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Socialize and incentivize population at the bottom of the pyramid to accelerate the vaccination drive

Socialize and incentivize population at the bottom of the pyramid to accelerate the vaccination drive

Dr. Rajan Samuel, Managing Director, Habitat for Humanity India

The outbreak of the first wave of the Covid-19 pandemic in early 2020 battered world economies, threw global manufacturing and supply chains into disarray and disrupted jobs and livelihoods. The impact of the pandemic was highly devastating on emerging economies like India. With the government announcing a nationwide lockdown and stringent physical distancing norms to curb the spread of the virus, distressed populations comprising migrant laborers, sanitation workers and daily wage earners were at a higher risk of entering into a perpetual cycle of debt and poverty. While the first wave of the pandemic caused severe social and economic repercussions, the second wave of the pandemic emerged as a grave existential crisis for vulnerable populations and their families.

Prime Minister Narendra Modi declared India’s fight against the Covid-19 pandemic by announcing the launch of the world’s largest vaccination drive in January 2021. Approval and authorization were given to the manufacture and deployment of several vaccines, with a large number of them in various stages of clinical development. Guidelines issued by the government stipulated that in the initial phases of the vaccination, priority would be given to healthcare workers and frontline personnel like police and civic staff. A major portion of the population across diverse social strata and economic backgrounds have been covered under the inoculation drive. However, a large section of vulnerable populations and their families living at the extreme bottom of the social and economic spectrum continue to remain excluded from the vaccination coverage.With little or no access to basic healthcare services, poor and unhygienic conditions, lack of awareness, knowledge, low-income families are highly susceptible to contracting the infectious diseases like the coronavirus. In order to curb the plausible third wave in the country, there is an urgent need to expand the outreach of the national Covid-19 vaccination plan to cover marginalized communities in the country’s urban and rural areas.

The outbreak of the second wave of Covid-19 led to a surge in daily caseloads and resulted in high death tolls. It also brought to the fore a stark digital divide between elite tech-savvy populations and marginalized communities not having access to digital platforms and suffering from lack of digital literacy and awareness.Though the mass reach of the inoculation program has been adversely impacted due to vaccine shortages, access to the internet has been key in ensuring that the digitally-literate sections of the population have an advantage to get access to vaccination slots while poor sections of the populations and their families have largely remained outside the ambit of the vaccination drive. As the positivity rates for the pandemic witness a drop in urban areas, a spurt in Covid-19 cases in rural areas will exert heavy pressure on the already fragile healthcare infrastructure in the country’s hinterlands. The pandemic has played a key role in exposing the urban-rural gap which has widened on account of low internet penetration, sporadic connectivity and lack of access to digital resources especially in the extreme remote villages of the country. It is high time that populations from marginalized sections of the society are equipped with basic digital skills to bring them into the digital mainstream.They should also be trained to use social media platforms and digital channels as communication tools for gaining and disseminating information on vaccination schedules and spreading online community awareness about the importance of getting vaccinated.

Language also continues to be a key barrier in large sections of underprivileged populations. In a country where not more than 10 percent of the population speaks the English language1, registrations for vaccine slots can only be made in English on the Cowin app. Provisions should be made to facilitate transactions in one local language in addition to English which will make it easy and convenient for marginalized communities toregister for vaccine bookings via the online route.

The health ministry has stated that offline registration for Covid-19 vaccines is being currently allowed in only government Covid-19 Vaccination Centers (CVCs). The ministry has further reiterated that private Covid-19 centres will need to follow the online slot booking process. The government should encourage private healthcare players to facilitate the offline registration process for Covid-19 vaccination of eligible beneficiaries belonging to the underprivileged populations. The government should take support from grassroot and local NGOs to generate positive awareness among the population. This will help in accelerating and socialising the vaccination drive across the country. The Union and State governments should also make it mandatory for private hospitals to administer the vaccine to distressed populations and their families free of charge. The government can explore the possibility of subsidising private healthcare facilities to incentivise them to expand the scale and scope of their vaccination program for marginalised families. 

There is also an urgent need to address the issue of vaccine hesitancy among underprivileged populations and their families. It will be an uphill task to gain the trust of communities who have traditionally been exploited and kept out of the social and economic mainstream. Still, there should be a determined effort to engage these communities in healthy conversations and explain to them the benefits of vaccination as a protective measure against the pandemic.Concerted community-based education campaigns should be undertaken with support of local NGOs to clear preconceived notions about the vaccine in the minds of people and encourage them to get vaccinated in large numbers.

As the second wave of the Covid-19 pandemic ebbs substantially and we witness a fall in the country’s active caseloads, predictions point to the outbreak of a third wave towards the end of the year. It is high time that the government formulates an effective and inclusive Covid-19 vaccine policy to ensure that there is no disparity in its coverage and access. The government needs to device a monitoring tool, that will track the number of people vaccinated in every family.

There is a need to accelerate vaccine production and distribution timelines once their efficacy and integrity has been proven. Sufficient stocks of vaccines should be allocated for the poor and their families. They should be vaccinated on a priority basis after studying their health history and examining co-morbidities if any.Vaccinated families can be incentivised either in cash through cash transfer or in-kind through public distribution system to encourage population to get vaccinated. Vaccination must not be a privilege but a right for all sections of the population. Granting equitable vaccination access to vulnerable populations needs to become a public health priority and a key corollary in the fight against Covid-19.

1 https://www.bbc.com/news/magazine-20500312

 




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