Even though the Covid-19 pandemic has abated, the road to recovery remains challenging for low and middle-income countries (LMICs) like Bangladesh, speakers said.
A coordinated effort from different stakeholders from a very early stage is extremely crucial to tackle future pandemic, especially for LMICs, they mentioned in a webinar.
SAJIDA Foundation hosted the webinar titled “Covid Landscape in Low- and Middle-Income Countries (LMICs): Lessons Learnt from Experience and Impact of Covid-19” on Monday.
The webinar was divided in two plenary sessions highlighting the experience, impact and policy implications.
Speakers presented their research findings on the challenges of Covid-19 in LMICs from the perspectives of patients, healthcare providers, and family members, and discussed during and post-pandemic mental and physical health impact.
They also showcased findings on LMIC responses to the pandemic and shared lessons to be learned from the experience of a Bangladeshi NGO.
From SAJIDA Foundation's experience, a framework has been proposed to prepare for future pandemic-like situations. This framework would be very useful for the policymakers, especially the government of low- and middle-income countries to provide stewardship by collaborating with NGOs for devising a response plan for something like a pandemic.
The pandemic's impact and related restrictions have also raised widespread concerns, particularly with recent evidence showing an increase in mental health problems. LMICs with weak health systems have still been reported to struggle, and the prevalence of comorbidities has increased the risk of direct and indirect consequences of Covid-19 on populations, including Bangladesh.
The sessions also focused that although challenges faced during pandemic, especially on mental health were quite similar among Botswana, Sri Lanka, India and Bangladesh, the contributing factors were quite different.
Although Bangladesh was ahead of other countries in dealing with Covid-19 pandemic situations, however, in Bangladesh, the evidence of mental health-related signs and symptoms of Covid was hardly investigated and even less on physical health-related signs and symptoms.
Study: 45% of people reported mental health issues
A study on the mental aspects of 481 patients and physical aspects of 420 (18 years and above) recovered and returned home during the Covid-19 period at SAJIDA Hospital showed that 45% participants reported at least one mental health related symptoms like depression, anxiety and stress.
Almost 50% reported changes in income and expenditure. Almost 92% reported reduced earning and 86% increased expenditure.
The research showed that any of the mental health related symptoms significantly concentrated among the participants with lower expenditure and the poor socio-economic population.
Dr Tanvir Ahmed and Asibul Islam Anik recommended their combined presentation to drive specific research and policy actions appropriate for resource poor settings like Bangladesh. The research focused on population and clinical research to understand the sociodemographic and economic clustering and pattern of both mental and physical health-related post Covid-19 consequences. Guidelines to screen and manage mental and physical health-related post Covid-19 consequences was also presented especially at the primary health care level.
The research targeted to devise an appropriate referral system and rehabilitation plan to help people with such burdens.
At that time Professor Shamini Prathman presented Sri Lanka's situation during Covid-19 and said that not only Covid sufferers, health workers such as doctors, nurses were also victims of mental health issues.
According to the research data presented by her – out of 385 health care workers, everyone has some mental issue. She recommended that the biggest stigma in mental health is that many don't talk about it out of fear. This leads to other psychological issues such as depression, anxiety and stress. Unlike other diseases, mental health needs a great deal of attention specially in terms of Covid and future pandemics.
Magen Mutepfa, associate professor, Department of Psychology, Faculty of Social Sciences, University of Botswana, presented the situation during Covid-19 and said: "In Botswana 326,500 Covid-19 cased caseshave been registered. Among them were 2,783 deaths and 32,3717 recoveries
All stakeholders should take cognizance that pandemics would happen, hence the need for health promotion activities, and proactive provision of better QOL, free internet service and sustainable, inclusive practices to build resilience and preparations to deal with them is essential, she added.
24.5m new poor due to Covid-19
In the second session, fellow of the Royal Society of Public Health, UK, Dr Tanvir Ahmed presented a report titled “LMIC Response to the Covid-19 Pandemic: Lessons to Learn from the Experience of a Bangladeshi NGO”.
The report said that during the Covid-19 pandemic, the economic impact resulted in 24.5 million new poor. More than 2 million garment workers were unemployed by the end of March 2020. The socioeconomic and health-related impact of Covid-19 has been deadly for low- and middle-income countries.
During the pandemic situation, capacity of the government of LMICS was stretched beyond the limits and NGOS played a crucial role in aiding the governments to respond. The government of Bangladesh responded to the pandemic together with other local and international NGOS.
SAJIDA Foundation (SF) recognized the need for a multidimensional response.
Learning from SAJIDA's experience, a framework has been proposed to prepare for future pandemic-like situation. The framework includes capability assessment, collaboration, compassionate leadership and clear communication.
This framework can be very useful for the policymakers, especially the government of low- and middle-income countries to provide stewardship by collaborating with NGOs for devising a response plan for something like a pandemic.
At the same time, additional resources need to be allocated for emergency provision of Covid-19-related healthcare keeping the economic and other health and development activities ongoing.
Regarding what to do to deal with future pandemics Professor Indranil Mukherjee said: "I think there are some things that India can learn from Bangladesh in this regard. For example, how the civil society of Bangladesh has worked together on Covid. However, data collection is necessary to improve the medical and financial system to deal with future pandemics. In this way, we will get idea about how to deal with the future pandemic situations."
Zarina Nahar Kabir said: "The world is now safe from Covid-19. But its impact is still there. Financial, mental and physical health are still affected by the pandemic. Proper planning is needed to meet such challenges for present as well as the future."
Professor Ahmed Mushtaque Raza Chowdhury said: "Bangladesh is doing well despite many problems. Civil society and various NGOs have worked together to fight against Covid-19. Today we heard about SAJIDA Foundation. But apart from some foreign funded NGOs, small NGOs are drowning due to lack of funds. Hope the Bangladesh government will help these NGOs to continue their services.”
SAJIDA Foundation is a value-driven non-profit organization which embodies the principle of corporate philanthropy, with 51% shareholding of Renata Ltd, one of the fastest growing pharmaceutical and animal health product company in Bangladesh.
The organization founded in 1993 aims to empower communities, catalyse entrepreneurship, and build equity through multisectoral programs, financial services and enterprises for good with an overarching vision of ensuring health, happiness, and dignity for all.
The sessions were chaired by Zarina Nahar Kabir, PhD, associate professor in the Department of Neurobiology, Care Sciences, and Society at Karolinska Institute and Ahmed Mushtaque Raza Chowdhury, PhD, professor of Population and Family Health at Columbia University and adviser to the James P Grant School of Public Health at Brac University.
Speakers included Ahmed Jojan Nandonik and Asibul Islam Anik from SAJIDA Foundation, Dr Tanvir Ahmed, fellow of the Royal Society of Public Health, UK; Associate Professor Magen Mutepfa from the University of Botswana; Professor Shamini Prathman from Sri Jayawardenepura University, Sri Lanka; and Professor Indranil Mukherjee from the Jindal School of Government and Public Policy, India.
