Challenges and solutions adopted by frontline health managers in the management of routine health services during the COVID-19 pandemic at the grassroots level in India: A qualitative quest.

Background: The public health emergency due to COVID-19 has placed an immense burden on the health care system. The strain for provision of health care services has also extended to routine services. The future impact of this decline in facility provision can be seen in morbidity and mortality indicators of the country. In a time when the country is working toward meeting the sustainable development goals (SDGs), COVID-19 has become a setback. Objective: This study tries to find the very challenges faced by frontline workers and the measures adopted to overcome the same. Materials and Methods: This was a mixed methods study conducted at various selected states across the country based on their vulnerability index. Data was collected via in-depth interviews among 120 frontline managers. Transcribed responses were coded. Framework analysis with preformed codes were done. Quantitative data are represented as frequencies and percentages. Results: Analysis showed increased work pressure, innovative approach adopted locally, and allaying fear by reinstating services helped as coping mechanisms to take care of routine health care services at the grassroots level. Conclusions: The conscious effort of all involved with the use of local solutions and innovations, along with intersectoral coordination and efficient use of resources paved the way for a good deliverance of health care to the society. The frontline managers minimized the damage by using available resources consciously and wisely.