Lessons from slums during COVID-19 in Indore and Agra, India towards better preparedness for future pandemics
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Urban Health Resource Centre, New Delhi, India
Urban Health Resource Centre, India
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A371
Background and Objective: COVID-19 led to adverse effects on the urban poor relating to healthcare, nutrition, children’s education, livelihood. The research aimed at learning challenges, coping method of families who faced difficulty in access to healthcare, food supplies, livelihood disruption, children’s education. Lessons point to preparedness measures for future disasters. Methods: We conducted in-person qualitative interviews, with open-ended probes with women of 40 slum families and with 10 key informants. Results: Many Government and private hospitals refused non-COVID services during lockdown. With frontline workers on COVID duty, pregnant women, children missed essential immunisation and maternity services leading to maternal and neonatal illness, deaths. Uncertain livelihoods, low access to social benefits made slum dwellers, mostly informal workers vulnerable. Many faced food-insecurity. They resorted to private hospitals and incurred debt. Those with previously stored grains could tide through food insecurity. School closure affected children’s education. Online classes were partially feasible for many. They could not afford phones, laptops and sustained internet access that better-off city dwellers had. Conclusions: Lessons for future include having more hospitals and clinics for routine health services. Co-opting nurses, other paramedical personnel on medium-term contracts can prevent/mitigate interruption of outreach health services and help Indian, LMIC cities better deal with future disasters. Inclusion of the urban poor (who provide low-wage services to cities) in extending essential services, and social protection schemes is vital during future pandemics. Ensuring access to food supplies mitigates suffering of the urban poor. Decentralised free food distribution with the help of schoolteachers, other government functionaries is crucial to prepare for similar future crises. An employment guarantee program for the urban poor similar to India’s Rural Employment Guarantee Scheme needs to be rolled out. Onsite classes in settlements with open spaces nearby is a way to extend education to deprived children during future disasters/pandemics.