Snakebite care through the first two waves of COVID-19 in West Bengal, India: a qualitative study

• Published in: Toxicon X Vol. 18; p. 100157
• Main Authors: Bhaumik, Soumyadeep, Beri, Deepti, Zwi, Anthony B., Jagnoor, Jagnoor
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2023; The Authors. Published by Elsevier Ltd; Elsevier
• Subjects: Access to care; COVID-19; Health systems; India; Quality of care; Snakebites; COVID-19; Health systems; Access to care; Quality of care; India; Snakebites
• ISSN: 2590-1710; 2590-1710
• DOI: 10.1016/j.toxcx.2023.100157

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 in 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. [Display omitted] •COVID-19 influenced snakebite care in a multitude of ways during the different waves of COVID-19 in India.•The choice of health care provider for snakebite is multi-factorial in origin and not solely determined by tradition.•Multi-faceted community programs for snakebite can contribute to improving health systems resilience.•Community programs for increasing formal health service use, should be accompanied by health systems strengthening.