Cannot have tubular vision, need multidisciplinary approach to public health: Dr Pradeep Awate

Maharashtra's state surveillance officer says public health infrastructure in urban areas still has a long way to go and there is a need to develop and implement comprehensive urban health planning with better coordination.

The state surveillance officer of Maharashtra Dr Pradeep Awate feels that a multidisciplinary approach to public health is necessary while dealing with the Covid-19 pandemic.

“Our task force at state or district level is full of clinicians. Our entire approach to deal with the pandemic was more or less hospital-centric. We can not ignore clinicians or hospitals but we should not forget the necessity of a multidisciplinary team to deal with such a complex pandemic,” Dr Awate has said in his editorial `Pandemic lessons: Are we ready to learn’, published in the Indian Public Health Association’s newsletter (July-Sept 2021).

“This is a historical moment for public health experts and planners to pause, introspect and revisit all pandemic lessons and most importantly try to implement them. Public health has never acquired such a central stage of public discourse as it has during this pandemic. The backbencher has moved to front benches, thanks to the Covid-19 pandemic, some good out of bad, Awate said.

“There are socio-political impacts of this health event. It could be the kind of social cover that has to be provided to the marginalised population in the event of a lockdown or now with the reopening of schools, the involvement of educationists is vital. Hence we cannot afford to have a tubular vision to the issue,” Awate told The Indian Express.

Apart from clinical protocol and hospital preparedness, we need to devise policies about lockdowns, social safety schemes during lockdowns, vaccination, future predictions of the pandemic, mental health issues, and convincing masses to follow covid-appropriate behaviour. We cannot afford to forget the multidisciplinary nature of public health, Awate said.

Dr Awate emphasised that there is a huge requirement of public health experts, immunologists, psychologists, sociologists, economists, bio-statisticians, human resource managers, behaviour scientists, to list a few.

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“Another lesson of the pandemic is it asked us to pay more attention to our urban areas. We do have some public health infrastructure in rural areas, thanks to the Bhore committee. Rampant urbanisation is a post-1990 phenomenon. Though the National Urban Health Mission has tried to bridge the yawning gap between necessity and availability of public health infrastructure in urban areas, we still have miles to go. In Maharashtra, where more than half of its population is dwelling in urban areas, we need to develop and implement comprehensive urban health planning,” he said.

“There is another issue of interdepartmental coordination when we consider urban health. We have nearly 27 municipal corporations and more than 350 municipal councils in Maharashtra which are working under the urban development and urban administration departments respectively. The public health of these urban local bodies is working under these departments and have no coordination with the public health department of the state on a day-to-day basis. We need to rethink the present system and introduce a more efficient system under one umbrella of public health, Dr Awate said.

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