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Migrant workers walk along a road to return to their villages, during a 21-day nationwide lockdown to limit the spreading of coronavirus disease (COVID-19), in New Delhi, India, March 26, 2020. REUTERS/Danish Siddiqui - RC2RRF992GP2

India’s lockdown will have serious demographic and health costs

Aii Analysis: COVID-19 and India

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Migrant workers walk along a road to return to their villages, during a 21-day nationwide lockdown to limit the spreading of coronavirus disease (COVID-19), in New Delhi, India, March 26, 2020. REUTERS/Danish Siddiqui

On 26th March 2020 the Government of India announced a 21-day lockdown as a means of preventing the spread of Covid-19. However, the lockdown is sudden, poorly conceived and underprepared. Existing commentaries have focused especially on the impacts of the lockdown on general poverty or access to food. It’s impact on people’s capacity to obtain healthcare is also a critical issue.

A sudden order to close a considerable number of private hospitals, essential medical services, and pharmacies, particularly in small and medium towns are making and will make huge damage to demographic and health outcomes. 62% of hospital beds in India are in the private sector.

At the all India level, on an average 6.9 million people visit for outpatient care and 110 thousands visit for inpatient care on daily basis, out of which, Private health care service providers caters for 66% of daily health care needs1. The closures will have potentially catastrophic implications for the large numbers of people in India living with chronic conditions, such as diabetes.

At the same time, mobility restrictions associated with the lockdown are preventing frontline health workers from attending to basic health care provisions during pregnancy, delivery care, and new-born health care. As many as 49,481 births take place per day of which private hospitals perform 55% of the caesarean and complicated deliveries.

The lockdown is also likely to reduce people’s access to Antenatal Care Services (ANCs). Even before the lockdown, roughly India was characterised by 120 pregnancy-related deaths per 1,00,000 live births and 37 child deaths per 1000 live births compared to 6 per 1,00,000 and 0.77 per 1000 for Australia in the same categories. In India, it accounts for 3600 women deaths per month and 2800 child deaths per day.

Other pressing issues include the postponement of child immunisation, declining availability of contraceptives and menstrual hygiene products, and deteriorating mental health – young people may be especially affected given the disruption to the academic year and job losses.

Centre and states must monitor other health care needs and medical requirements through public and private partnerships during the lockdown. The state should subsidise health care services in private sector hospitals .