The Fact Maker

Swasti takes quality healthcare to doorsteps of communities with high risk of COVID-19 infection with support from The Rockefeller Foundation

The second wave of COVID-19 devastated the country; led to overburdening of the health system and particularly impacted the vulnerable and marginalized communities as access to timely information, diagnosis and medical care became even more scarce than usual for this section of the population. Swasti has launched an ambitious program to take healthcare to the doorstep of communities at high-risk of COVID-19 infection. In the initial phase, this project will be rolled out in Bengaluru and Mumbai with consideration to expand to other geographies such as Delhi, Uttar Pradesh, Bihar and Jharkhand at a later time. The objective is to provide high quality community-based care during COVID-19, allowing infections to be identified early and breaking the chain. The program will help in detecting early symptomatic cases of COVID-19 using active screening and community-based testing in areas identified as hot spots or potential hot spots for COVID-19 and ‘Treat at home and intervene early’: Support safe community level and home-based isolation and care for COVID-19 patients with mild-moderate symptoms and escalate issues early to reduce mortality. The Rockefeller Foundation has given Swasti a grant of $ 750,000 over two years to undertake this program.

Outlining Swasti’s approach to the program, Dr. Angela Chaudhuri, Swasti said, “Our response is intended to be hyper-local. Most mild-moderate COVID-19 patients are extremely reluctant to go to a hospital setup and prefer to be treated at home. Therefore, our program uses people’s homes or community institutions to serve them with community surveillance along with home-based primary care support, dedicated sample collection and testing support at or near their doorstep. This will also help in reducing the avoidable use of limited public health resources, providing access to those who need it the most.”

The second wave has uncovered an urgent need for interventions to serve COVID-19 positive patients from vulnerable communities to ensure care for these patients and to reduce the burden on the healthcare system. Speaking about the significance of taking healthcare services to the doorsteps of communities at high-risk of COVID-19 infection, DeepaliKhanna, Managing Director, Asia Regional Office, The Rockefeller Foundation said, “The Rockefeller Foundation has a long history of working with organizations to improve health and well-being in India and around the globe. This grant builds upon these previous collaborations and are part of our commitment to supporting an equitable response and recovery to this pandemic and preventing future ones.”

Talking about the initiative, PurnimaRanawat, Swasti said, “Bengaluru and Mumbai were some of the hardest hit cities in the second wave of COVID-19. Therefore, we will do active surveillance in these cities covering at least 1,00,000 population and scale vaccination services, perform antigen tests at community level, support home isolation, triage, and connection to tertiary care for those that need it. The number of tests each month will change as the arc of the pandemic evolves.”

As COVID-19 has struck communities in high density urban slums, they face a range of problems that hinder access to primary care in general and COVID-19 services in particular. Swasti’s teams,rooted within these communities, work with a multi-pronged approach to better prepare the population for any surge in infections. Active surveillance and Tele-care for primary care and COVID-19 issues, innovative testing modalities such as self-testing and community-based testing and facilitating vaccination access for the most vulnerable are some of the key strategies being deployed. In Bengaluru, mass vaccination camps organized for vulnerable urban poor, sex workers and trans populations were also layered with additional services such as screening for diabetes, hypertension and anemia as lack of primary care access in these populations has meant these common and manageable conditions often go un-noticed or untreated till it’s too late.

As apparent, this pandemic demands intervention at different levels of care. While intervening at community level will be key and serve most of the population, building capacity of an overburdened critical care system will be important as well. These interventions will not only improve health outcomes in an efficient, community-centered setting but also significantly reduce the burden on the public health institutions.