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GIRNAR GUJARAT’S INTERIM REVIEW of NOTEWORTHY ACTIONS in RESPONSE to COVID-19 an Intra-Action Review

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GIRNAR GUJARAT’S INTERIM REVIEW of NOTEWORTHY ACTIONS in RESPONSE to COVID-19 an Intra-Action Review GUJARAT State Health System Resource Centre Gujarat GIRNAR GUJARAT’S INTERIM REVIEW OF NOTEWORTHY ACTIONS IN RESPONSE TO COVID-19 An Intra-Action Review GUJARAT State Health System Resource Centre Gujarat GIRNAR Gujarat’s Interim Review of Noteworthy Actions in Response to COVID-19 An Intra-Action Review INDIAN INSTITUTE OF MANAGEMENT AHMEDABAD Vastrapur, Ahmedabad, Gujarat 380015 Opp. Airforce Head Quarters, Nr. Lekawada Bus Stop, Lekawada CRPF P.O Gandhinagar , Gujarat India – 382042 GUJARAT State Health System Resource Centre Gujarat First floor, NHM Bhavan, Civil hospital campus, Sector 12B, Gandhinagar - 382012. Gujarat World Health Organization Country Office - India R.K. Khanna Tennis Stadium, Africa Avenue, Safdarjung Enclave, New Delhi - 110029 TABLE OF CONTENTS List of abbreviations ............................................................................................................ v Preface ............................................................................................................................... xi Executive summary ......................................................................................................... xiii Intra-action review lead team .............................................................................................xx 1. Intra-action review methodology ..................................................................... 1 2. COVID-19 and Gujarat .................................................................................... 3 3. Strategies, challenges and recommendations ................................................. 9 Pillar 1: Coordination, planning, and monitoring ..................................................... 9 Pillar 2: Risk communication & community engagement ................................... 13 Pillar 3: Surveillance, response, and containment ............................................... 18 Pillar 4: Points of entry capacities ......................................................................... 22 Pillar 5: Laboratory capacities and quality assurance .......................................... 24 Pillar 6: Infection prevention and control .............................................................. 27 Pillar 7: Case management & hospital preparedness .......................................... 30 Pillar 8: Operational support & logistics ................................................................ 35 Pillar 9: Research, innovation & knowledge sharing ............................................. 37 Pillar 10: Maintaining essential health services .....................................................41 4. Conclusions and way forward ....................................................................... 45 5. References .................................................................................................. 47 iii 6. Annexures ................................................................................................... 48 Intra-action review support team ........................................................................... 48 Acknowledgements ...............................................................................................49 List of stakeholders ................................................................................................ 50 iv LIST OF ABBREVIATIONS AEFI Adverse Event Following Immunization AIIMS All India Institute of Medical Sciences AMC Amdavad Municipal Corporation ANM Auxiliary Nurse Midwife AOP Association of Paediatricians APMC Agriculture Produce Market Committee ARI Acute Respiratory Infection ART Anti-Retroviral Therapy AS Aarogya Setu ASHA Accredited Social Health Activist AYUSH Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy BJMC B. J. Medical College BMJ British Medical Journal BMW Bio-Medical Waste CBNAAT Cartridge- Based Nucleic Acid Amplification Test CCIC COVID-19 Community Isolation Centres CCMC Certificate Course in Management of COVID-19 CCTV Closed-Circuit Television CDGR Compound Daily Growth Rate CDHO Chief District Health Officer CEO Chief Executive Officer CHCs Community Health Centres v CHO Community Health Officers CISF Central Industrial Security Force CM Chief Minister CMO Chief Minister’s Office COO Chief Operating Officer COVID-19 Coronavirus Disease CoWIN Covid Vaccine Intelligence Work CPO Chief Personnel Officer CrPC Criminal Procedure Code CSBC Centre for Social and Behaviour Change CSO Civil Service Organizations DG Director-General DIKSHA Digital Infrastructure Knowledge Sharing EMRI Emergency Management and Research Institute e-OPD Electronic-Outpatient Department FDCA Food and Drug Control Authority FLW Front Line Worker FOGSI Federation of Obstetrics and Gynaecological Societies of India FW Family Welfare GEM Government E-Marketplace GIS Geographic Information System GMERS Gujarat Medical Education & Research Society GMSCL Gujarat Medical Services Corporation Limited GoG Government of Gujarat GoI Government of India GSDP Gross State Domestic Product Gunupati Venkata Krishna Reddy – Emergency Management and GVK-EMRI Research Institute H&FWD Health and Family Welfare Department HCW Health Care Workers vi HFNC High Flow Nasal Cannula HFW Health & Family Welfare Human Immunodeficiency Virus and Acquired Immune Deficiency HIV/AIDS Syndrome HR Human Resource HTP High Threat Pathogen IAP Indian Academy of Paediatrics IAR Intra-Action Review I-CAD Infection Control Assist Device International Statistical Classification of Diseases and Related Health ICD Problems ICDS Integrated Child Development Services ICMR Indian Council of Medical Research ICU Intensive Care Unit IDSP Integrated Disease Surveillance Program IEC Institutional Ethics Committee IFA Iron and Folic Acid iGOT Integrated Government Online Training IHBT Immuno Hematology & Blood Transfusion IHIP Integrated Health Information Platform IHR International Health Regulations IIMA Indian Institute of Management Ahmedabad IIPHG Indian Institute of Public Health Gandhinagar ILI Influenza Like Illness IMA Indian Medical Association IPC Interpersonal Communication IPC Infection Prevention and Control IT Information Technology ITIHAS Integrated Hotspot Analysis System vii LART Link Anti-Retroviral Therapy LCD Liquid Crystal Display LED Light Emitting Diode MBBS Bachelor of Medicine and Bachelor of Surgery MD Managing Director MO Medical Officers MoU Memorandum of Understanding MPHW Multipurpose Health Worker MS Medical Services NABH National Accreditation Board for Hospitals & Healthcare Providers NGO Non-Governmental Organization NHM National Health Mission NIC National Informatics Centre National Initiative for Developing and Harnessing Innovations- Techno NIDHI-TBI Business Incubator NQAS National Quality Assurance Standards NTEP National Tuberculosis Elimination Program OSD Officer on Special Duty PDU Pandit Dindayal Upadhyay PH Public Health PHC Primary Health Centre PHCs-MO Primary Health Centres - Medical Officers PIB Press Information Bureau PLWHA People Living with HIV /AIDS PoE Points-of-Entry PPE Personal Protective Equipment PPP Public-Private Partnerships RAT Rapid Antigen Test (for COVID-19) RCCE Risk Communication and Community Engagement RKS Rogi Kalyan Samiti viii RRTs Rapid Response Teams RSS Rashtriya Swayamsevak Sangha RT-PCR Reverse Transcription–Polymerase Chain Reaction SARI Severe Acute Respiratory Infections SBCC Social and Behaviour Change Communication SHSRC State Health System Resource Centre SIHFW State Institute of Health and Family Welfare SMIMER Surat Municipal Institute of Medical Education and Research SOP Standard Operating Procedure SQAS State Quality Assurance Standards SSC State Steering Committee SSGH Sir Sayajirao General Hospital Thiamine, Ascorbic Acid, Zinc, Heparin, Oxygen therapy, Prone TAZ-HOPES-T position, Eliminate exertion, Steroids, Tocilizumab TB Tuberculosis THR Take-Home Rations UHCs Urban Health Centres UNDP United Nations Development Programme UNICEF United Nations Children’s Fund USP Unique Selling Proposition WHO World Health Organization ix x PREFACE Ever since the World Health Organization (WHO) declared the outbreak of 2019 novel coronavirus (COVID-19) as a public health emergency, the Government of India and the Government of Gujarat have collectively undertaken and implemented several pandemic responses that include measures on preparedness, prevention, mitigation, control and recovery. Gujarat, in particular, has developed its own operational response plan and implemented several strategic measures to combat the spread of COVID-19 and secure the welfare of its people. Acknowledging the fact that the COVID-19 pandemic is likely to continue in the near future, it becomes imperative to review the ongoing responses of the state administration. The objective and motivation behind this is to qualitatively review the public health management actions already undertaken, to identify the current best practices, the achievements and the challenges faced. This process of response review is knowledge enriching in itself and may help all interested stakeholders in improved handling of public health emergencies that enables long-term health security. This review used a new WHO tool developed for country intra-action reviews (IAR). The review report highlights important success factors and provides recommendations across ten important areas. The review also documents the challenges that the stakeholders faced while dealing with the outbreak and recommends critical improvements required to ramp up the health response.
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