Covid impedes stats on other diseases

Covid-19 has remained the primary focus of the healthcare system for the past 1.5 years, pushing alleviation of other diseases and medical concerns to the backseat.

In the meanwhile, however, it appears that ailments which had been brushed aside have now started manifesting into graver threats, landing the northwestern province of Khyber Pakhtunkhwa into yet another quandary.

Now beginning to rub its eyes to reality, the provincial government’s latest realisation has been the upsurge in Chitral’s infant mortality rate, which despite augmentation has managed to remain out of the record books of the health department.

This is vividly reflected from the fact that when contacted by the provincial headquarters for more information on the matter, the district health office was found to be lacking details of the case.

In addition to that, District Health Information System (DHIS), which collects data from the entire province, compiles it and analyses it for 43 different communicable and non-communicable diseases from hospitals across the province, is also yet to file details of the first half of 2021.

Per relevant officials, it is the pandemic’s onslaught which diverted the government machinery’s attention from record-keeping of other prevalent diseases. When the novel coronavirus first sank its claws into Khyber Pakhtunkhwa (K-P) in March of 2020, there was already a dearth of officials deputed for routine tasks.

“With the pandemic’s burden, the K-P government was compelled to order staff to pause core duties and join the workforces deputed to fight Covid-19,” said one health department official on condition of anonymity.

The first step was closing the Out-Patient Departments (OPDs) at hospitals for around six months in order to prevent the viral infection from spreading. It did stop the flow of patients, but since emergency services were provided without any suspension, the only recorded details that emerged during this period were related to accidents and emergencies.

“This is where we left our core job,” commented a DHIS senior health official. “We left reporting data on 43 different diseases because what we were told to do was more important than reporting,” he added.

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According to the data available with The Express Tribune, a sharp decline was observed in data reporting of diseases across the province during this period. As compared to 23.9million people who visited hospitals in 2019, some 21.3 million people visited health facilities in 2020 and that too for different communicable and non-communicable diseases. Whereas, report for first six months of the year 2021 is reportedly being analysed and awaiting compilation.

The 2020 report read that some 9.1million visited health facilities in first half of the year and 12.1 million people in the second half. Among approximately 21.3m who visited health facilities, 14.58 per cent were those with Acute (upper) Respiratory Infections in the first half where the number was reduced to 13.40 per cent in the second half of the year 2020.

In addition to that 3.74 per cent patients visited hospitals reporting fever due to other miscellaneous causes between January to June 2020 where the ratio increased [for symptoms like Covid-19] to 3.85 per cent in the last six months.

Similarly, 1.01 per cent of the total 9.1million patients visited hospitals for Asthma but it dropped to 0.96 per cent in the second half besides 0.76% and 0.90% for Enteric and Typhoid fevers respectively. The report mentioned that 0.05 per cent of the total visitors checked for Sexually Transmitted Infections in the first half as compared to 0.6 per cent in the second half but not a single case was reported during the whole year.

On the other hand, the number of people who visited health facilities in 2019 was higher than 2020 since a total of 23.9million people visited health facilities with 12.58 persons for Acute (upper) Respiratory Infections, 3.59 per cent for fever due to other causes, 2.24 per cent for tooth decay, 1.15 per cent for worm infestation, 0.98 per cent for Asthma, 0.83 per cent for Enteric/Typhoid Fever, 0.5 per cent for Sexually Transmitted Infections and some 0.00003 per cent of the total 23.97million people visited health facilities suspecting HIV/AIDS infection in 2019.

Officials said there were fewer people at offices, owing to most being transferred to other offices including Khyber Medical College, Emergency Operation Centre and Peshawar Institute of Cardiology. They termed the transfer a reason for the lack of analysis for data between January to June 2021. “Only emergency services besides surgeries and deliveries were reported however an analysis will be done later this year,” shared one officer.

When asked about the ratio which dropped in 2020, Director General Health Dr Niaz informed that a Monitoring and Information System was still in place and data was still being reported. “But the OPD services were closed and there was a fear of infection, so people were also reluctant to visit hospitals,” Dr Niaz told The Express Tribune. “OPDs were closed, so procedures were suspended and some 500 beds of the Lady Reading Hospital alone were dedicated to Covid-19 patients, people did not visit hospitals. If you don’t have people visiting health facilities, what do you record and what do you send to the provincial headquarters,” he asked rhetorically.

Published in The Express Tribune, August 17^th, 2021.