Home Health People With NCD Face Multiple Challenges

People With NCD Face Multiple Challenges

Bhubaneswar: People with chronic non-communicable diseases (NCDs) faced multiple challenges in accessing health care in Khurda district during the pandemic, finds a study.

The Regional Medical Research Centre (RMRC), Bhubaneswar and Kalinga Institute of Medical Sciences (KIMS) have jointly conducted the mixed-method study in Khurda district during May-June 2020. The report was published on Monday. 

A total of 491 individuals having at least one NCD participated in this study. Among the participants, 51 per cent (252) were males.

The study findings revealed that nearly two-thirds of participants encountered challenges in their routine investigation (69%), day-care procedures (67%) and reaching hospital (61%).

Around half of them reported having trouble in doctor appointments (59%), emergency treatment (56%), access to the pharmacy (47%) and delay in healthcare (46%).

Similarly, 37 per cent perceived that they could not access health care because of social restriction/lockdown, 29 per cent attributed arranging finance as a constraint to visiting hospitals and 16 per cent avoided going to the hospital, fearing Covid-19 infection, the study report says.

“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,” it said.

Respondents with multimorbidity (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 said.

The study also found that family network was the primary source of support among the respondents (96%); and about three per cent relied on their friends and neighbours.

Most respondents declined or postponed regular appointments wherever possible. Regarding the management of their illnesses during the pandemic related lockdown period, many confided that they either continued the same medicine or adjusted the doses according to their symptoms.

Some avoided large hospitals for consultation, preferring a small private clinic or pharmacist shop or village doctors (informal healthcare providers), the study further said.

However, some urban participants tried to substitute their routine check-ups by self-care measures like monitoring their blood glucose using test strips and blood pressure with the help of family members or neighbours.

Some of the participated patients also tried to avail teleconsultation or consulted their physicians through telephone or internet-based platforms. However, non-availability of their health records and background information on treatment was the major challenge while approaching a new physician on a telemedicine platform.

The National Health Policy-2017 in India stressed digitalization in the healthcare sector. In August 2020, the National Digital Health Mission (NDHM) was launched in India to achieve universal health coverage and which aims to build a holistic and inclusive digital health environment to streamline healthcare delivery.

Therefore, telemedicine-enabled healthcare with disease-specific virtual clinics is a pre-requisite for contactless physician-patient interaction. Digital/electronic records are critical for future pandemic preparedness plans.

However, digitization is not the only solution, but only one of the components of the overall pandemic response strategy. Therefore, a decentralized network of doctor-pharmacy-patients is necessary to tackle the NCD treatment needs during public health emergencies, it said.