Covid-19 lockdown governance in Uttar Pradesh, India: a call for equity?

Abstract

AbstractThe COVID-19 pandemic has reflected the weaknesses in the already collapsing health systems of the countries. In India, there has been a mass exodus of migrants during the lockdown, witnessed by the world. We undertook a qualitative data analysis to examine the governance arrangements, decision-making processes and implementation of policies during the pandemic in the state of Uttar Pradesh, India. Methods We did a qualitative study using thematic analysis. The participants (n = 16) were recruited from the district(n = 4), state (n = 6) and centre (n = 6) level using purposive sampling. They participated in in-depth interviews between May 2020-July 2020 by phone/zoom. Interviews were transcribed verbatim, and data were analysed using Dedoose software. Ethical approval was obtained from the King George Medical College, Lucknow, Uttar Pradesh, vide registration ECR/262/Inst/UP/2013/RR-19 Findings We recruited participants (15 males and 1 female), and five theme categories emerged from the data analysis. These were: 1) Centralized decision-making with decentralized implementation, 2) Consultative processes for decision-making but little emphasis on consensus building, 3) Informal channels of communication and enhanced intersectoral coordination, 4) Community involvement leading to transparency, and 5) Enhanced inequities during the crisis. Results Lessons learnt from examining governance and decision-making in one state of India reveal the need for reducing inequities and attention to primary ethical considerations in times of humanitarian crisis. Going forward, we need to work towards building resilience into the health system and increasing the role of decentralized participatory decision-making and governance. The use of digital technology and social media platforms greatly facilitated the response during the pandemic and can be capitalized on more in the future as a global health policy matter.

Keywords

• Covid-19
• governance
• lockdown
• policy research
• Komalsingh Rambaree, Social Work and Criminology, University of Gävle, Gävle, Sweden
• Asian Studies; Health & Development; Sociology