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By Rohit Kumar Singh
Covid-19 continues to march forward, but now some relief may be on the horizon. With over 20 vaccine candidates in the pipeline and a handful of candidates now in phase-III, we await promising results.
The Serum Institute in Mumbai has already started manufacturing the Oxford/ AstraZenca vaccine in anticipation of promising results, with over a billion doses earmarked for India. Nandan Nilekani, in a recent article, laid down a compelling roadmap to facilitate distribution of the vaccine at an unprecedented scale, much beyond the routine immunization programmes for pregnant women and children.
He posited we should train vaccinators en-masse with tools like Project Echo, create blueprints for pop-up and mobile vaccination stalls, authenticate vaccinations over Aadhaar, issue incentive-based vouchers using UPI, and issue portable digital certificates that could serve as immunity passports.
But health is a state subject. For India’s largest state, Rajasthan, local jugaad will be needed to provide equitable access to the vaccine for over 8 crore residents across 50,000 villages. I believe we must first leverage our existing delivery system. This is a golden opportunity to strengthen existing supply chains and human resources already responsible for distributing vaccines and antenatal care at village health and nutrition camps.
Altogether, the secondary benefits of strengthening the supply and demand of routine immunization may be more impressive than protection from Covid itself. Rajasthan is well-poised to strengthen this delivery system because now over 50,000 community health workers from the ASHA level to the medical officer are technologically-enabled.
Everyday this workforce logs over 100K household health visits, referrals and follow-ups on our Mission Lisa mobile app. Through this effort, we now have highly-granular spatial data to highlight areas most likely to be left out. To ensure the vaccine reaches the beneficiary an accountability mechanism will be needed for offline contexts.
Offline biometrics may be a viable alternative to Aadhaar in our rural villages. However, we will need to consider new approaches as well. Contactless biometrics – whether fingerprint or face – will need to be integrated into the smartphones of our health workers.
To support the ASHA, each village now has 2 additional helping hands in the form of Swasthya Mitras – who are now seamlessly connected with health policy updates through decentralized Whatsapp networks. These Swasthya Mitras will amplify the awareness communication required to overcome fear, distrust, and stigma that may crop up at the grassroots level. Perhaps self-help groups of women, tremendously reliable on loan repayments, can be upskilled to ensure local awareness and uptake of the new vaccine as well.
Additionally, we have data-driven approaches to send automated IVRS messages and direct benefit transfers to drive demand at the last mile. Communication will be the most important pillar in this effort.
Finally, we will also need local innovation to support the supply chain and transcend our current limitations. Mobile towers and solar power can be leveraged to extend the ice-line-refrigerator cold chain near the last mile. Micro-entrepreneurs can receive loans and incentives electronically to extend the cold chain of vaccines to the village level, as measured by remote sensor technology in mobile vaccine carriers. A Pulse-Polio approach of bringing vaccines to the doorstep of marginalized and nomadic communities must be considered as well.
So the time is ripe for innovation – across government departments, civil society, development partners and entrepreneurs. Rajasthan has always taken the lead in egovernance and e-health. Here, we will tie tradition with technology to make an impact at scale, ensuring no one gets left behind.
(The writer is the additional chief secretary, department of rural development & panchayati raj, government of Rajasthan)
Covid-19 continues to march forward, but now some relief may be on the horizon. With over 20 vaccine candidates in the pipeline and a handful of candidates now in phase-III, we await promising results.
The Serum Institute in Mumbai has already started manufacturing the Oxford/ AstraZenca vaccine in anticipation of promising results, with over a billion doses earmarked for India. Nandan Nilekani, in a recent article, laid down a compelling roadmap to facilitate distribution of the vaccine at an unprecedented scale, much beyond the routine immunization programmes for pregnant women and children.
He posited we should train vaccinators en-masse with tools like Project Echo, create blueprints for pop-up and mobile vaccination stalls, authenticate vaccinations over Aadhaar, issue incentive-based vouchers using UPI, and issue portable digital certificates that could serve as immunity passports.
But health is a state subject. For India’s largest state, Rajasthan, local jugaad will be needed to provide equitable access to the vaccine for over 8 crore residents across 50,000 villages. I believe we must first leverage our existing delivery system. This is a golden opportunity to strengthen existing supply chains and human resources already responsible for distributing vaccines and antenatal care at village health and nutrition camps.
Altogether, the secondary benefits of strengthening the supply and demand of routine immunization may be more impressive than protection from Covid itself. Rajasthan is well-poised to strengthen this delivery system because now over 50,000 community health workers from the ASHA level to the medical officer are technologically-enabled.
Everyday this workforce logs over 100K household health visits, referrals and follow-ups on our Mission Lisa mobile app. Through this effort, we now have highly-granular spatial data to highlight areas most likely to be left out. To ensure the vaccine reaches the beneficiary an accountability mechanism will be needed for offline contexts.
Offline biometrics may be a viable alternative to Aadhaar in our rural villages. However, we will need to consider new approaches as well. Contactless biometrics – whether fingerprint or face – will need to be integrated into the smartphones of our health workers.
To support the ASHA, each village now has 2 additional helping hands in the form of Swasthya Mitras – who are now seamlessly connected with health policy updates through decentralized Whatsapp networks. These Swasthya Mitras will amplify the awareness communication required to overcome fear, distrust, and stigma that may crop up at the grassroots level. Perhaps self-help groups of women, tremendously reliable on loan repayments, can be upskilled to ensure local awareness and uptake of the new vaccine as well.
Additionally, we have data-driven approaches to send automated IVRS messages and direct benefit transfers to drive demand at the last mile. Communication will be the most important pillar in this effort.
Finally, we will also need local innovation to support the supply chain and transcend our current limitations. Mobile towers and solar power can be leveraged to extend the ice-line-refrigerator cold chain near the last mile. Micro-entrepreneurs can receive loans and incentives electronically to extend the cold chain of vaccines to the village level, as measured by remote sensor technology in mobile vaccine carriers. A Pulse-Polio approach of bringing vaccines to the doorstep of marginalized and nomadic communities must be considered as well.
So the time is ripe for innovation – across government departments, civil society, development partners and entrepreneurs. Rajasthan has always taken the lead in egovernance and e-health. Here, we will tie tradition with technology to make an impact at scale, ensuring no one gets left behind.
(The writer is the additional chief secretary, department of rural development & panchayati raj, government of Rajasthan)
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