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?:abstract
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This article explores the likely spread of Covid-19 to rural areas in India and the preparedness of Indian rural healthcare systems to meet the demands created by the pandemic Less well recognized are the lockdown\'s adverse impacts on the social determinants of health and on access to essential health services If the impact of this disease is similar to that of earlier contagious diseases like TB, it will have a greater adverse impact on socio-economically disadvantaged populations For example, although both infection and case fatality are higher in males, 70 per cent of health and social service staff, globally, are women, putting them at a higher risk of contracting Covid-19 Also, there are other gendered effects that flow from the lockdown, rather than the virus For instance, domestic violence increased globally during the 2014-16 Ebola and 2015-16 Zika epidemics, and is increasing during the Covid-19 pandemic as well Although India\'s Covid-19 death rates may be lower than elsewhere because of India\'s younger population, this demographic advantage may be offset by the threat of malnutrition One recent post-lockdown study by PRADHAN conducted in 12 States showed that 50 per cent of rural households are eating less than usual, and 68 per cent have reduced the number of food items from their meals The workforce in health must have regular employment It is difficult, if not impossible, to provide universal access to quality public services using only contractual or contracted-in employment If public policy supports a meaningful expansion of public sector employment, it could be an effective way to address burgeoning poverty and unemployment as well as the lack of social security across rural India
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