Facilitating COVID vaccinations in remote, rural India

Despite the recent rise in rural vaccinations, many states are still lagging. (Photo source: IE)

By Zarina Screwvala

The pandemic presented us with numerous challenges. Crippling medical infrastructure, the migrant crisis and the loss of employment in both urban and rural areas, the nation has dealt with it all. By September 2021 the country has administered more than 80 crores vaccinations, out of which 75% are the first dose and 25% are the second dose. COVID-19 vaccination is the only hope to prepare the country for any similar crisis in the future. However, it is a daunting task, especially in rural India.

The second wave hit the hinterland severely. With more than 1.4 billion people residing in rural India, it has been the government’s priority. In the middle of the year, while the efforts to inoculate citizens increased, the vaccine shortage and vaccine hesitancy crippled the efforts.

Despite the recent rise in rural vaccinations, many states are still lagging. So, to ensure the successful COVID vaccination drive in India, the vaccination has to reach the doorstep in the remotest villages. Our previous learnings from past campaigns like polio and my recent learnings from rural Maharashtra’s vaccination drive offer hope and can scale across the country.

1) Addressing COVID-19 hesitancy: While the rising number of jabs taken in the hinterland suggests that COVID-19 hesitancy is phasing out. However, the turnout in the remotest of villages, especially the tribal communities is low. Shobha Deshmukh, a community health volunteer, supported by a non-profit in Asanpoi village of Raigad, has been trusted by the community for all their primary health care needs. However, when she went to mobilize the community for vaccination, she was not well received and people asked her to leave. She took the support of vaccinated community members to share their experiences. Besides, the local Gram Panchayat head also helped in engaging with reluctant community members and building confidence among them. Together they were successful in breaking the myths of villagers and ensuring successful vaccinations in the community. The key learning is to create local heroes and let them communicate to build trust.

2) Mobile Vaccination Drives: For the remotest areas, the nearest vaccination centers are far. With limited connectivity, reaching these vaccination centers is a full day out for community members because of limited modes of transport. For many who survive on daily wages, skipping work for a day means no food on the table for the family that day. For elderly and specially-abled citizens too, traveling far is a challenge. In such cases, mobile vaccination drives have been successful. Raigad district administration took the initiative of the door-to-door vaccination drive supported by a non-profit with Mobile Vaccination Vans and has vaccinated over 15,000 rural community members in the remotest villages. In addition, these mobile vans can help in vaccination at places of workplaces of labor forces- on farms, commercial & project sites.

3) Rewards and recognitions for community trailblazers: Positive reinforcements in the community are a small but high-impact step in scaling up any initiative. This can be at local self-government or at the district level. Recognizing the community members doing exemplary work in mobilizing the villagers, can act as a positive reinforcement for the change-makers to continue their efforts. For example, the Gram Panchayat members of Turbe Khurd village in Poladpur felicitated the ASHA worker for her work during COVID-19 vaccination and management by replenishing her medical kits.

4) Community participation and ownership: While the government continues to head the vaccination drive across the country, the availability of frontline healthcare is limited and overworked. This can be best addressed if the community members and leaders take the responsibility of motivating and mobilizing villagers for vaccination.

I was impressed with what I recently saw in Raigad. Many village committees are supporting the vaccination drives by planning and providing logistic support. The community members are taking ownership by reaching out to the medical health centers to conduct vaccination camps in their village. In Barasgaon village, the turnout for vaccination was low. This is when ten empowered women mobilized the villagers by visiting each home, understanding their hesitations for vaccination and supporting them with necessary information through experts and experiences of vaccinated community members. They convinced the medical staff to schedule the camp again and these women organized and managed it. Approx 409 community members got vaccinated in the village.

5) While communities take lead at the grassroots, I believe that corporations should also take initiative in supporting vaccination drives in the vicinity of their operations. Partnering with the government, they can provide logistic support and/or by mobilizing communities in their operational areas.

The success of the COVID-19 vaccination drive needs faster coverage of the eligible population, and it is possible through stronger engagement with the communities, empowering them with correct messages, and executing the mobile vaccination drives timely. Active collaboration among all stakeholders – communities, non-profits, government health services and donors is critical. These learnings from rural India are simple and scalable solutions. It must and can be done to take us all out of this crisis and ensure a healthy, happy India.

(The author is a Co-founder of the Swades Foundation & works full time as its Managing Trustee/Director. She is also a member of the UN Women Business Sector Advisory Council (BSAC). She was also one of the Founder-Directors of UTV (now a part of the Walt Disney Company India. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)

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