COVID-19 pandemic versus six "A"s of health care services - accessibility, affordability, availability, appropriateness, adequacy, and adherence.

Background and Rationale: COVID-19 pandemic resulted in a huge setback in health care sector causing morbidity, mortality, lack of manpower, resources, in hospitals. Apart from the direct effects of the disease, the indirect effects include, lockdowns, restriction of movement of people for food, work, medicines, etc. There are certain non-communicable diseases for which lifelong treatment and continuation of care is required and the patients suffering from these diseases were also highly affected during pandemic. The major pillars of health care services are accessibility, affordability, availability appropriateness, adequacy and adherence and it is true that the pandemic had its impact on all these pillars. Methodology: A prospective cross sectional study in which 284 patients with NCD answered a questionaire and the responses were analysed. Results: There was a lack of accessibility (48%), affordability (42%) availability (54%) appropriateness and 71% of population took self-medication during the period. There was discontinuity in 16% of the population and the reasons for discontinuation include depression, lack of motivation, forgetfulness, financial crisis etc. Conclusion: The pandemic exerted a greater influence on saturation of health care services by increasing the mortality, morbidity and as a consequence decreased the health care services to communicable/non-communicable diseases. Our study shows the need and demand for robust health care services during critical times.