Disruptions, restorations and adaptations to health and nutrition service delivery in multiple states across India over the course of the COVID-19 pandemic in 2020: An observational study

• DOI: 10.1371/journal.pone.0269674
• Publication Date: 2022-07-27T17:45:50Z
• Authors: Rasmi Avula; Phuong Hong Nguyen; Sattvika Ashok; Sumati Bajaj; Shivani Kachwaha; Anjali Pant; Monika Walia; Anshu Singh; Anshuman Paul; Ayushi Singh; Bharati Kulkarni; Deepak Singhania; Jessica Escobar-A...; Little Flower Aug...; Madhulika Khanna; Maitreiyee Krishna; Nandhini Sundarav...; Prakash Kumar Nayak; Praveen Kumar Sharma; Prerna Makkar; Puspen Ghosh; Sadhana Subramaniam; Sai Mala; Rakesh Giri; Sameeksha Jain; Santosh Kumar Ban...; Sapna Nair; Sebanti Ghosh; Suman Das; Sumeet Patil; Tanmay Mahapatra; Thomas Forissier; Priya Nanda; Suneeta Krishnan; Purnima Menon
• Keywords: Pandemic; 2019-20 coronavirus outbreak

Background Modeling studies estimated severe impacts of potential service delivery disruptions due to COVID-19 pandemic on maternal and child nutrition outcomes. Although anecdotal evidence exists disruptions, little is known about the actual state at scale. We studied restorations, challenges adaptations in health by frontline workers (FLWs) India during 2020. Methods conducted phone surveys with 5500 FLWs (among them 3118 Anganwadi Workers) seven states between August–October 2020, asking April 2020 (T1) August-October (T2), analyzed changes T1 T2. also systems administrative data from 704 districts restoration services pre-pandemic (December 2019, T0), Results In (T1), village centers, fixed day events, growth monitoring, immunization were provided <50% several states. Food supplementation was least disrupted. T2, center-based restored over a third most Administrative highlights geographic variability both restorations. Most had for pregnant women children T2 but not yet reached T0 levels. Adaptations included home (60 96%), coordinating other (7 49%), use phones counseling (~2 65%). Personal fears, long distances, limited personal protective equipment, antagonistic behavior beneficiaries reported challenges. Conclusions Services mothers disrupted stringent lockdown thereafter, albeit Rapid policy guidance enabled remains uptake client populations. As continues surge India, focused attention ensuring essential critical mitigate these major indirect pandemic.