Yasobant Sandul, Patel Krupali, Tadvi Ravina, Thacker Hardi, Bruchhausen Walter, Saxena Deepak
Department of Public Health Science, Indian Institute of Public Health Gandhinagar (IIPHG), Gujarat, India.
Centre for One Health Education, Research & Development (COHERD), Indian Institute of Public Health Gandhinagar (IIPHG), Opp. Air Force Head Quarters, Nr. Lekawada, Gandhinagar, Gujarat, India.
BMC Health Serv Res. 2025 Jul 26;25(1):979. doi: 10.1186/s12913-025-13147-0.
The COVID-19 pandemic globally posed a great challenge to the existing healthcare system for delivering routine services. Community Healthcare Workers (CHWs) play an important role in delivering routine as well as COVID-19-related services at the forefront. Understanding the complexity of service delivery and the challenges faced by them is very crucial. This study aims to investigate the specific challenges for community-based routine healthcare services during COVID-19.
The cross-sectional study was conducted in Ahmedabad City, Gujarat, from November 2021 to October 2022. A mixed-methods approach was adopted for carrying out this study. Ahmedabad was selected as the site of this study as it is a large populous city and has witnessed the outbreak of other diseases like CCHF and SARS, and it also experiences a significant impact of Covid-19.
A total of 150 CHWs were included in the study for the quantitative survey, and nine CHWs were interviewed to gather qualitative information. The results show the disruption in the community-based routine services, especially during the first wave. Increased workload (93% of CHWs) was a major challenge during COVID-19 was one of the biggest challenges from the provider side, while fear of leaving the house (97%) was reported as one of the biggest challenges from the demand side. During the first wave, services for Non-Communicable Diseases (NCD) were highly affected. CHWs reported that they were motivated to work in the pandemic to provide the necessary care and services to the community. Findings from this study also suggest the need for structured training in emergency preparedness, mental health support, and coordination skills, with policy implications for urban health systems' resilience.
The results suggest that additional training for CHWs on pandemic response and infection control would be highly helpful during emergencies. Recruitment of trained human resources and intersectoral collaboration are very important for the appropriate management of and preparedness for such pandemics in future. These are some of the main pillars of strengthening the health system. This study uniquely contributes by documenting the use of CHWs in a large urban setting and highlighting innovative intersectoral collaboration mechanisms that emerged during the crisis. Further, this study provides an insight into the lessons learnt from the COVID-19 pandemic towards maintaining healthcare services during crises.
The online version contains supplementary material available at 10.1186/s12913-025-13147-0.
新冠疫情在全球范围内给提供常规服务的现有医疗体系带来了巨大挑战。社区医护人员在前沿提供常规服务以及与新冠疫情相关的服务方面发挥着重要作用。了解服务提供的复杂性以及他们所面临的挑战至关重要。本研究旨在调查新冠疫情期间基于社区的常规医疗服务所面临的具体挑战。
2021年11月至2022年10月在古吉拉特邦艾哈迈达巴德市进行了横断面研究。本研究采用了混合方法。选择艾哈迈达巴德作为研究地点，因为它是一个人口众多的大城市，见证了诸如克里米亚刚果出血热和非典等其他疾病的爆发，并且也受到了新冠疫情的重大影响。
共有150名社区医护人员纳入定量调查研究，9名社区医护人员接受访谈以收集定性信息。结果显示基于社区的常规服务受到干扰，尤其是在第一波疫情期间。工作量增加（93%的社区医护人员）是新冠疫情期间来自服务提供方的最大挑战之一，而害怕离家（97%）被报告为来自需求方的最大挑战之一。在第一波疫情期间，非传染性疾病服务受到严重影响。社区医护人员报告称，他们在疫情期间积极工作，为社区提供必要的护理和服务。本研究结果还表明，需要在应急准备、心理健康支持和协调技能方面进行结构化培训，这对城市卫生系统的恢复力具有政策意义。
结果表明，在紧急情况下，为社区医护人员提供关于疫情应对和感染控制的额外培训将非常有帮助。招募训练有素的人力资源和部门间协作对于未来此类疫情的妥善管理和准备非常重要。这些是加强卫生系统的一些主要支柱。本研究通过记录在大型城市环境中社区医护人员的使用情况以及突出危机期间出现的创新部门间协作机制做出了独特贡献。此外，本研究提供了对从新冠疫情中吸取的关于在危机期间维持医疗服务的经验教训的见解。
在线版本包含可在10.1186/s12913 - 025 - 13147 - 0获取的补充材料。
