02550nas a2200229 4500000000100000008004100001260001600042653001500058653001900073653001900092653001600111653001300127653001000140100001400150700001100164700001100175700001400186245010200200856015300302520185100455022001402306 2023 d bElsevier BV10atoxicology10aAccess to care10aHealth systems10aSnake Bites10aCovid-1910aIndia1 aBhaumik S1 aBeri D1 aZwi AB1 aJagnoor J00aSnakebite care through the first two waves of COVID-19 in West Bengal, India: A qualitative study uhttps://www.sciencedirect.com/science/article/pii/S2590171023000097/pdfft?md5=4c68287be0ff55e500b3644c5ede2506&pid=1-s2.0-S2590171023000097-main.pdf3 a
Snakebite is a public health problem in many countries, with India having the highest number of deaths. Not much is known about the effect of the COVID-19 pandemic on snakebite care. We conducted 20 in-depth interviews with those bitten by venomous snakes through the two waves of COVID-19 (March–May 2020; May–November 2021), their caregivers, health care workers and social workers in two areas (Sundarbans and Hooghly) of West Bengal, India. We used a constructivist approach and conducted a thematic analysis. We identified the following themes: 1. Snakebite continued to be recognised as an acute emergency during successive waves of COVID-19; 2. COVID-19 magnified the financial woes of communities with high snakebite burden; 3. The choice of health care provider was driven by multiple factors and consideration of trade-offs, many of which leaned toward use of traditional providers during COVID-19; 4. Rurality, financial and social disadvantage and cultural safety, in and beyond the health system, affected snakebite care; 5. There is strong and shared felt need for multi-faceted community programs on snakebite.
We mapped factors affecting snakebite care using the three-delay model (decision to seek care, reaching appropriate health facility, receiving appropriate care), originally developed for maternal mortality. The result of our study contextualises and brings forth evidence on impact of COVID-19 on snakebite care in West Bengal, India. Multi-faceted community programs, are needed for addressing factors affecting snakebite care, including during disease outbreaks-thus improving health systems resilience. Community programs for increasing formal health service usage, should be accompanied by health systems strengthening, instead of an exclusive focus on awareness against traditional providers.
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