Introduction
Humanity is experiencing a pandemic for the first time in the context of almost immediate information dissemination. In the case of India, in the middle of the pandemic outbreak, images of dead people on the streets and their mass burning spread worldwide (Ganguly, Misra, and Goli, 2020). Simultaneously, the pandemic in India demonstrated the highest growth in the number of cases worldwide and a shortage of oxygen.
There were also growing fears that the healthcare system would be unable to cope with the situation (Ganguly, Misra, and Goli, 2020). It is essential to note that the Indian healthcare system was not ready to respond to the first cases and help the infected at the height of the pandemic. The country’s hospitals lacked beds and oxygen, which meant that patients were denied treatment, and some families resorted to the black market for medicines.
Therefore, the research project aims to identify the challenges faced by Bihar during the Covid-19 pandemic and the lessons it has learned to apply them to the health sector.
Accordingly, the objectives of the study are:
- To determine the difficulties Bihar encountered during the Covid-19 pandemic;
- To recognize the lessons learned by Bihar in the fight against Covid-19;
- To evaluate the development of public health in Bihar after gaining experience in the fight against Covid-19.
According to the aims and objectives of the research proposal, the following questions need to be answered:
- What challenges did Bihar face during the spread of the pandemic?
- What are the main lessons learned by Bihar in the health sector during the Covid-19 outbreak?
- How has healthcare governance changed after the Covid-19 outbreak in Bihar?
Literature Review
Not many sources in contemporary literature explore the challenges India faced during Covid-19. This is because the authors who have worked on this topic only note the causes of the problems but do not indicate their origin and specificity in Bihar. Importantly, Godman (2020) examines the authorities’ response to healthcare problems during the Covid-19 outbreak. Accordingly, the author indicates a worldwide rush for protective equipment, medicines, and medical oxygen. Kasthuri (2018) identifies the main reasons that have negatively affected India’s fight against the pandemic. Therefore, the author notes that India’s healthcare development needed reforms.
This was especially evident in rural areas, where people were unaware of treatment methods and vaccination. Moreover, Kasthuri (2018) mentions that most villages did not have physicians, and infections were treated with non-traditional methods based on herbs and rituals.
However, the Indian authorities have assessed the negative state of healthcare and the lessons learned during the pandemic. Therefore, India has begun reforming its health care system. As a result, they adopted the strategies recommended by the WHO and considered the national aspect (Godman, 2020). One of these strategies is telemedicine, which provides remote patient consultations. George et al.(2020) also studied the challenges faced by India during the outbreak of the coronavirus pandemic. Finally, they concluded that the poor living in slums should be included in free healthcare programs.
The outbreak of COVID-19 in Bihar has become uncontrollable precisely because of the high number of poor people who could not receive treatment. Therefore, other states immediately began to change their approaches to treating all population groups. Kumar and Kumar (2020) indicate that the healthcare system in Bihar failed to cope with the pandemic. This is because the state has not had the resources to deal with it, resulting in one of the highest mortality rates. At the same time, they had no means of protection and were spreading awareness among the population, thus increasing the scale of the disaster.
Meanwhile, in the academic literature, authors often explore the lessons learned from the coronavirus pandemic in India but do not pay attention to the state of Bihar. Pal et al. (2020) note that the pandemic can only be controlled through coordinated action between the medical system and the population.
Therefore, at the state level, the authorities have initiated efforts to inform citizens about the means of protection against Covid-19. This lesson was learned from the example of Bihar when people could not obtain help or receive information about preventive protection. Iyengar et al. (2020) confirm the findings of Pal et al. (2020) that the early lessons learned by India from the outbreak, especially from the negative impacts in Bihar, have stimulated resource optimization and strengthening of infection control measures. They also found that adoption of telemedicine in Bihar is still lower than in more developed states.
The Lancet (2020) described the response of the Indian authorities to the Covid-19 outbreak and the first changes implemented. Consequently, the state has implemented preventive measures that are used worldwide, including closed borders, quarantine, and mandatory masks. As it was in the state of Bihar, where the authorities could not respond to the pandemic’s challenges in time, other states took various measures to prevent the disaster that occurred in Bihar.
However, changes in the healthcare system have not been uniform, resulting in extremely high mortality rates. Kerala, for example, successfully adapted and implemented the changes quickly and thus had a low mortality rate. The state government monitored contact with sick people and informed the population about all types of protection against COVID-19. Meanwhile, there is another example in Maharashtra, where drones were used to respond to quarantine violations.
In addition, Sharma et al. (2021) assess the impact of adopting the concept of herd immunity in India and advancing this method. Importantly, the authors emphasize that after the first positive changes, the Indian authorities have maintained the idea of herd immunity as a method of combating COVID-19. Along with that, considering the mistakes that led to the intensive spread of the infection, India introduced a national program that provided vaccination for the population.
Dey and Dey (2020) examine the mortality during the pandemic and note that Bihar was not immediately able to effectively implement nationwide security measures. This is due to the high level of transmission of the virus. However, the gap in their research is significant, as they describe how India implemented popular steps and strategies worldwide. All authors except Pal et al. (2020) and Lancet (2020) do not mention local incentives and the problems that arose in Bihar. Accordingly, this study aims to bridge this gap and describe the experience of implementing non-standardized solutions.
Sharma et al. (2021) estimated the effect of Covid-19 on India and highlighted lessons for the future of the public health system. Consequently, the authors argue that India has begun to increase funding for the health sector and purchase the necessary supplies after the mass deaths in the streets of Bihar state. Ghosh, Nundy, and Mallick’s (2020) findings confirm the conclusions of Sharma et al. (2021) about the need to continue healthcare reforms. The authors emphasize that current spending on enhancing health care will allow the Indian government to save money during the next wave of COVID-19. It is because all states, including Bihar, will be prepared to adopt rapid measures to combat the pandemic.
Meanwhile, Rakshit and Basistha (2020) analyzed the economic impact of the pandemic on India. As a result, the authors conclude that only improving medical care can allow India to establish trade routes with other countries. This is because, after the COVID-19 epidemic, almost all governments struggle to control their borders and cooperate with countries in the Third World to prevent a new pandemic outbreak.
Therefore, Rakshit and Basistha (2020) confirm the findings of Ganguly, Misra, and Goli (2020) that public health systems need security-centric financing to ensure that the state complies with security requirements. Therefore, the Indian government, after the active fight against COVID-19, began to introduce programs for preventive protection of the population and the development of health services. Hence, the authors noted the impact of lessons learned from the COVID-19 pandemic on improving public health in India. Nevertheless, they have described only the general directions that the government has chosen to address. Consequently, the study will analyze in more detail the effect of COVID-19 on the Indian healthcare system after the lessons learned in Bihar.
Research Process
It is crucial to notice that the proposal will have a philosophy of pragmatism; this methodological paradigm is suitable for studying society, people, and culture. Meanwhile, it is based on a universal method of solving problematic situations by reconstructing experiences and forming a research strategy. Therefore, this approach is suitable for consolidating the lessons learned by the Indian authorities during the Covid-19 pandemic. The research approach combines data collection and analysis requirements to achieve the research objectives. Additionally, research approaches define a disciplined approach or method to achieve different research objectives.
Thus, mixed methods will establish reliable data under the proposal’s goals. The research methodology includes using qualitative and quantitative methods to collect and analyze data. Thus, surveys will be used to collect primary data. This method is suitable for data collection because it follows the principles of mixed-method research. This is because the survey will include questionnaires with scaled responses and will contain descriptive questions with detailed answers.
To conduct a qualitative study and collect reliable and valid data for the proposal, the survey will focus on Bihar. This is because it is one of the states that has suffered the most from the COVID-19 pandemic, and it is in this state that the bodies of the dead were thrown into the river. Accordingly, the surveys will be conducted among healthcare workers in the state who have had experience with COVID-19 and have continued to work in hospitals. They will be selected using the simple random sampling method, allowing for a non-random selection of people to be interviewed from a list of healthcare workers. As a result, this method will enable unbiased surveys to be conducted that should demonstrate the challenges and changes in the healthcare sector in Bihar.
Furthermore, ethical considerations and principles will be considered while conducting the research. In this way, survey participants will be involved voluntarily and will have the opportunity to refuse to participate. In addition, signing an informed consent is a prerequisite for ensuring their rights and fulfilling their obligations. Additionally, the reliability of the study will be ensured through the use of mixed-methods research. This is because a sample of people can answer questions with multiple answers, and then researchers can compare their written answers to the same issues. The availability of a comprehensive literature review on the topic ensures the study’s validity. Hence, the study’s findings can be compared with those of other researchers.
Resources Access for Primary and Secondary Data
Significantly, it is crucial to collect reliable secondary data to analyze the available information. Accordingly, I will use scientific articles published in medical journals. Thus, access to databases such as JSTOR, Google Scholar, and Gale Databases. Moreover, the research on the impact of COVID-19 on the healthcare sector in India indicates the need to use the most recent sources that comply with the academic criterion of time. This will permit me to obtain the most recent research on the issue and compare it with the results of this study. Consequently, I periodically review the literature and have purchased access to databases for unlimited access to scientific literature.
In addition, to obtain valid and sufficient primary data, I am already consulting with the heads of healthcare facilities in Bihar. This will enable me to get the support of the hospital management and facilitate the survey among the employees. In addition, to obtain holistic information from a sample of healthcare workers, survey questions are already being developed based on the information already known from secondary sources. Hence, the permission and support of the hospital management and an optimal list of questions will provide the required data.
References /Bibliography of planned reading
Dey, J. and Dey, S. (2020) ‘SARS-CoV-2 pandemic, COVID-19 case fatality rates and deaths per million population in India’, Journal of Bioinformatics, Computational and Systems Biology, 2(1), pp. 100-110.
Ganguly, D., Misra, S. and Goli, S.(2020) ‘India’s COVID-19 Episode: resilience, response, impact and lessons’, Social Science Research Network. Web.
George, C. et al. (2020) ‘Challenges, experience and coping of health professionals in delivering healthcare in an urban slum in India during the first 40 days of COVID-19 crisis: a mixed method study,’ BMJ Open, 10(11), pp. 1-10. Web.
Ghosh, A., Nundy, S. and Mallick, T. K. (2020) ‘How India is dealing with COVID-19 pandemic’, Sensors International, 1, p. 1-10. Web.
Godman, B. (2020) ‘Combating COVID-19: lessons learnt particularly among developing countries and the implications’, Bangladesh Journal of Medical Science, 103, pp. 1-10. Web.
Iyengar, K. et al. (2020) ‘Learning opportunities from COVID-19 and future effects on health care system,’ Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(5), pp. 943-946. Web.
Kasthuri, A. (2018) ‘Challenges to healthcare in India-The five A’s’, Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 43(3), pp. 130-141. Web.
Kumar, A. and Kumar, M. (2020) ‘Covid-19 and the public health system in Bihar,’ Political Weekly, 55(16), pp. 16-19.
Lancet, T. (2020) ‘India under COVID-19 lockdown’, Lancet, 395(10233), pp. 1310-1315. Web.
Pal, R. et.al. (2020) ‘Comparison between two different successful approaches to COVID-19 pandemic in India (Dharavi versus Kerala),’ Journal of Family Medicine and Primary Care, 9(12), pp. 5820-5827. Web.
Rakshit, B. and Basistha, D. (2020) Can India stay immune enough to combat COVID‐19 pandemic? An economic query,’ Journal of Public Affairs, 20(4), pp. 2150-2157. Web.
Sharma, N. et al. (2021) ‘Combating COVID-19 pandemic in India: demystifying the concept of herd immunity’, Journal of Family Medicine and Primary Care, 10(4), pp. 1510-1515. Web.