People with two or more chronic non-communicable diseases (NCD, multi-morbidity) encountered multiple challenges in accessing healthcare during Covid-19 pandemic in Khordha district, revealed a recent study.
The study titled ‘Non-communicable diseases care during COVID-19 pandemic: A mixed-method study in Khurda district of Odisha, India showed that almost half of the participants had difficulties in managing their NCD-related care during the Covid pandemic.
Diagnostic services, physician consultation, transport arrangements, financial constraints, mandatory self-isolation, the need for social distancing and fear of visiting hospitals for risk of COVID-19 infections were the major perceived challenges.
The study was carried out in Khordha during May-June 2020 by three institutes-The Regional Resource Hub, Health Technology Assessment in India, ICMR-Regional Medical Research Centre, Bhubaneswar and Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar.
A total of 491 individuals having at least one NCD participated in this study.
According to participants, during the COVID-19 pandemic, diagnostic services (n=187, 38 percent) were among the most significant barriers towards seeking treatment while doctor consultation (n=93, 19 percent) was the second most experienced challenge.
Around 15 percent (n=74) faced problems accessing emergency care while 14 per cent (n=69) had some difficulties either in visiting hospitals, and/or purchasing medicines. Approximately 37 per cent (n=182) perceived that they were not able to take care of their chronic illnesses because of the prevailing social restriction/lockdown.
The findings indicated that 29 per cent (n=142) reported financial arrangement as a constraint towards visiting hospitals and 16 per cent (n=79) feared going to hospitals apprehending getting COVID-19 infection.
Respondents with multi-morbidity (the presence of more than one chronic condition) residing in urban areas expressed substantially higher problems than individuals having a single condition and residing in rural areas.
It was found that the family network was the primary source of support among the respondents (96 percent) and about three percent relied on their friends and neighbours.
Qualitative findings revealed that before the onset of the pandemic, participants managed their NCD conditions by routinely visiting hospitals or physicians. Almost all considered their routine treatment as a lesser priority during the pandemic compared to the threat of COVID-19.
The study concluded that ‘A cohesive doctor-pharmacy-patient engagement is vital for managing NCD care during a pandemic. During emergencies, changes in dispensing practices such as duration and person, and service provision closer to the patient are crucial.’