Strategies to mitigate COVID-19 need to be tailored to a local context and severity of outbreak

We’ve all experienced the impact of COVID-19 on our lives in the past two years and even if you haven’t had COVID, there is no denying the effect it has had on physical and emotional health.  According to UNICEF, the pandemic has been brutal for the 58% of Indians who live on less than USD 3.10 per day, and therefore the impact on health will likely be fully understood only in years to come. As per the NFHS round 5 (19-21), there has already been attention to the increase in anaemia among children, adolescents and pregnant women. The Observer Research Foundation notes that the gains made in the past with regards to attendance in schools, child marriage and adolescent fertility are likely to be lost if we do not take urgent action for mitigation, even as we account for the current status of the pandemic. The disruptions in the healthcare system, with diversion towards COVID-19 response has also affected the delivery of various programs - immunisation, deworming, ante-natal and postnatal care etc., as per a journal published in The Lancet. Postpartum depression and intimate partner violence were significant concerns even prior to the pandemic and have been exacerbated during the pandemic, noted an article in the Reproductive Health. The most significant requirement for mitigation is to enable a localised response, since COVID-19 waves have peaked and declined at different times across the country. The timetable of implementation must be tailored to not just COVID-19 severity but also to the local context and needs of the people. According to the Observer Research Foundation (ORF), globally about 8.5% of all reported COVID cases were from children and adolescents (0-18) and the available evidence in India suggests similar trends in India. Our efforts to re-open anganwadis and schools to ensure that children and adolescents return must be our number one priority. Schools do not create an environment for learning, they are central to our programs for nutrition and empowerment. Anganwadi and school closure must be the last in the community and they must be the first to open; even decisions to close or open must be made at Block level so that disruptions are limited to locales where there may be a surge of infections. Since a large number of children, especially girls, have likely dropped out of schools, we will need to ramp-up our efforts and focus on identifying and bringing these children back into schools and other community interventions (neighbourhood school, village libraries etc) that support their health and well-being. This last mile effort will not be possible without collaboration of the state and civil society organisations that have a focus on vulnerable groups. COVID vaccinations saw coordinated efforts at District and Block level to go door to door and enable vaccination. Building on these efforts, children, adolescents and pregnant women’s health will need to be prioritised - not just for one-time delivery of food-grains or check-ups, but to ensure that these groups remain engaged with programs that are meant for them. Hence, district and block level coordination and planning efforts which include people’s collectives and civil society organisations are going to be essential. This is also necessary because many assumptions are made about the needs of children, adolescents and pregnant women - while there may be common characteristics, there are often significant differences as well - sexual minorities, caste, class, religion, disability - require understanding and adaption for inclusion, notes an article on International Journal of Disaster Risk Reduction in Science Direct. Life skills and emotional well-being focused programs in schools as well as community-interventions will go a long way in not only dealing with the aftermath of the pandemic but in also enabling adolescents to be better equipped to deal with the demands of adulthood. According to the World Bank, social protection has been recognised as an important system that enables people to deal with shocks and crises and there can be no better time that allowing for adaptation of social protection programs as per the local needs of people, so that the urgency of support for children, adolescents and pregnant women are not left to the availability of budgets. As per the International Monetary Fund, a strong governance is an important factor if we are to powerfully contain the fallout of the pandemic on adolescents and pregnant women. We will need to empower and finance local decision making by panchayats, ward committees; giving people an opportunity to be at the table and have a say was never more important than now - if we are to truly mitigate the impact, we must stop thinking of children, adolescent and pregnant women as beneficiaries and recognize and enable the agency that they have. The author is the CEO of Swasti - a global public health agency and Chair of Asia Pacific Alliance for Sexual and Reproductive Health and Rights. Views expressed are personal.

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