Government issues guidelines on Covid-19 management in rural, peri-urban areas

According to the SOP, in every village, active surveillance should be done for influenza-like illness

With 490 districts reporting more than 10 per cent test positivity, the Union Health Ministry on Sunday released a guideline to spruce up the health infrastructure in rural areas where Covid-19 infections are feared to be heading to.

The guideline comes a day after Prime Minister Narendra Modi asked for the augmentation of healthcare resources in rural areas to focus on door to door testing and surveillance, besides empowering the ASHA and Anganwadi workers with all necessary tools.

The ministry asked the administration to set up village clinics to check influenza like illness and severe acute respiratory infections besides training the community health officers and auxiliary nurses and midwives on RAT test and other aspects of Covid-19 detection so that they can identify the patients and guide them appropriately.

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The aim would be to triage the symptomatic cases at village level by teleconsultation with community health officers so that cases with comorbidity and low oxygen saturation should be sent to higher centres. Every subcentre has been advised to run a dedicated ILI/SARI out patient service.

Since 80-85 per cent Covid-19 patients are asymptomatic or mildly symptomatic, who can be cured at home, the guideline suggests providing a home Isolation kit to all such cases.

The kit would contain medicines like paracetamol 500 mg, ivermectin tablet, cough syrup and multivitamins besides a detailed pamphlet indicating the precautions, medication and monitoring proforma.

Health experts while welcoming the move pointed out it would be a challenge to implement particularly because of manpower shortage in the rural areas, which overburdened the ASHA and ANM workers.

“Rome was not built in a day nor can rural public health response be established overnight. Frontline workers need to be supported by augmenting their capacity, community based volunteers who are trained. But it is reassuring to note that there is a focus on strengthening the rural response,” Oommen John, a senior public health researcher at the George Institute for Global Health told DH.

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“The field workforce could be augmented by recruiting local residents with required qualifications and be trained in standard operating procedures for home based testing using rapid diagnostic tests in combination with digital tools needed for decision support to facilitate triage and referral.”

At a review meeting on Saturday, Prime Minister Modi said that localised containment strategies were the need of the hour specially for states where test positivity rate in districts was high. The Prime Minister instructed to scale up the testing further with use of both RT PCR and RAT.

Earlier this week, the Indian Council of Medical Research recommended setting up round the clock RAT booths up in cities, towns and villages. Such booths can be set up at all government and private health care facilities to screen the maximum number of people without any need for an accreditation.