The COVID-19 pandemic has been a watershed moment in global health, as well as one of the most difficult challenges we’ve ever faced during our time. After witnessing the plight over the last two years, it demands immediate attention at the national and state levels to ensure readiness for a better healthcare system in order to adequately manage unforeseen situations in the future.
BIHAR: With the foundation of Critical Care Working Groups, the state government, in partnership with AIIMS, Patna has established a detailed action model to equip the existing health care system and come up with a suitable critical care service for COVID-19 patients, recognizing the need and emergence necessitated by the pandemic in all the districts across the state including District Hospitals (DH), Sub- Divisional Hospitals (SDH), and government Medical Colleges (MC) in the state.
At the state level, the CCWG at AIIMS Patna has made a giant step forward by successfully implementing this model in Bihar with the help of the USAID-funded and Jhpiego-led RISE initiative. The Bihar government’s goal of developing and operationalizing ICUs in all the districts along with several sub-divisional and primary health care centers is what the body is envisioned at.
Further, the CCWG has been employed to do a gap analysis of the current situation to identify infrastructure and training needs, with the cooperation and guidance of CCWG, AIIMS Patna, and the USAID RISE project. CCWGs at the district level are to provide oversight and overall advice to the RISE initiative, which is financed by USAID and led by Jhpiego, in contextualizing interventions based on the facility’s need to respond to the pandemic quickly. Various adoptions regarding evidence-based protocols and fundamental quality standards in critical care and patient care are to be made, particularly in the context of the COVID-19 pandemic, in accordance with national requirements. For a seamless implementation of the action plan, the CCWGs at the district level are to interact with the CCWG team at AIIMS Patna on a regular basis to discuss clinical treatment management difficulties in COVID-19 along with a periodical review wherein the opportunities and challenges are to be discussed. Further, the model is aimed at providing oversight and facilitation for training based on the critical care training needs identified by RISE for trainee doctors and nurses. The team is also to develop a system for monitoring clinical outcomes in the critical care unit using an e-dashboard.
The first State Level CCWG meeting was held in a virtual format on September 27, 2021, with the help of the CCWG team, AIIMS Patna, and the USAID RISE project. Civil surgeons, district-level government health officials, and heads of government medical colleges were all those who attended the meeting from around the state at a common ground and goal of forming CCWGs at the district level.
235 health professionals were trained in seven batches between June and August 2021, with 90 of them being chosen as ToTs based on overall scores such as post-test scores, knowledge, skill, competency, and attitude.
The plan that the state is envisaging opens up diverse responsibilities for the team. It demands proper preparation, training and a thorough plan and audit to be carried out in a defined period with better coordination with sub-level CCWGs across the state.