Health program’s resilience and chronic disease during COVID-19 pandemic

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This article was exclusively written for The European Sting by Ms. Behnaz Rahati, a 5th-year medical student from the Golestan University of Medicine, Iran and a member of the Medical Students Iranian Association (a member of (IFMSA)). She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


In the course of the COVID-19 pandemic, the health systems gap and weaknesses in existing plans showed themselves. An unpredictable disconnection in Health programs management and coordination as a result of lack of properness, occurs in most parts of the world. With all efforts of healthcare systems, fast and constantly changing situations put the health programs in the danger of disruption and failing. The first and most important approach was quarantine and besides all of the challenges, it was implemented widely in most countries. Also, restrictions on the use of hospital and ambulatory services were imposed and all elective, routine, and non-urgent patient procedures were canceled regarding the special and urgent situation that COVID brought.

Primary health care centers were implemented to promote better health outcomes for individuals with chronic conditions through monitoring, management, and follow-up.  Telehealth, virtual specialty consults, and remote primary care visits were other innovative ways to reduce the harmful aspect of getting out of routine pathways. But as we saw in practice, at the first level of care in urban or rural clinics was the majority of old people who abandon their routine of care. In developing countries with a low-income level, disruption of routines in the existing health system with all financial issues which COVID-19 imposed on countries and people make the health system so fragile. Messaging to stay at home with fears of attending primary care facilities or using public transport, makes people leave their plan of care or screening and we saw patients with severe chronic conditions who haven’t visited their doctor for almost two years during the pandemic.

As medical students, perhaps the best way to learn from recent experience and build back better is to ensure preparedness for the next emergencies.  Having a comprehensive plan and clear guidelines, advocating in making policies for similar situations can lead to a more proper and adequate response at the time of emergencies. Information collecting and data analysis of gaps and weaknesses can make a better understanding of how patients with chronic disease have been affected during COVID-19 pandemic and plan for future programs at local and regional levels.  In the end, being trained and transferring this knowledge peer to peer is crucial for building a stronger health system for other emergencies.

References

  1. Schmidt ME, von Fricken ME, Wofford RN, Libby RC, Maddox PJ. Access to Care During a Pandemic: Improving Planning Efforts to Incorporate Community Primary Care Practices and Public Health Stakeholders. World Medical & Health Policy. 2020 Sep;12(3):274-81.
  2. 2. Mitchell S, Maynard V, Lyons V, Jones N, Gardiner C. The role and response of primary healthcare services in the delivery of palliative care in epidemics and pandemics: A rapid review to inform practice and service delivery during the COVID-19 pandemic. Palliative Medicine. 2020 Oct;34(9):1182-92.
  3. Lauriola P, Martín-Olmedo P, Leonardi GS, Bouland C, Verheij R, Dückers ML, Van Tongeren M, Laghi F, Van Den Hazel P, Gokdemir O, Segredo E. On the importance of primary and community healthcare in relation to global health and environmental threats: Lessons from the COVID-19 crisis. BMJ Global Health, 6 (3), 1–7.
  4. Kendzerska T, Zhu DT, Gershon AS, Edwards JD, Peixoto C, Robillard R, Kendall CE. The effects of the health system response to the COVID-19 pandemic on chronic disease management: a narrative review. Risk Management and Healthcare Policy. 2021;14:575.

About the author

Behnaz Rahati is a 5th-year medical student from the Golestan University of Medicine and a member of the Medical Students Iranian Association (a member of (IFMSA)). She is a former local officer of the Standing Committee on Sexual and Reproductive Health and Rights and General Assistant of Vice President for International Affairs. She is passionate about sexual health and rights and public health management.

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