Improving Access to COVID-19 Testing in India through Systems Strengthening
PATH
The Rockerfeller Foundation
Background
COVID-19 was an unprecedented health crisis globally, bringing life to a standstill. As health systems crumbled in its wake, its impact was felt far and wide, especially in India, with around 33 million confirmed cases and 445,000 fatalities as on 3 September 2020. Yet, the country was testing less than 0.1% of its population at that time. The need for continuous testing and mass vaccination was evident and so was the need to evaluate barriers and enablers to uptake of testing and vaccination and devise solutions thereof.
About the Study
In keeping with MIHM’s vision to support the government’s efforts to disrupt Covid-19 transmission through increased testing, it is working to develop an efficient, cost-effective, and sustainable pandemic-containment model/response through differentiated testing strategies, networking of laboratories, and accelerated deployment of innovations. Simultaneously, it is supporting the policymakers in designing Covid-19 response tools/guidelines/standard operating procedures (SOPs) and facilitating peer-learning by leveraging the e-learning systems and digital solutions.
This study aims to:
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Understanding the factors affecting uptake of COVID-19 testing and vaccination
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Outlining differentiated solutions to boost uptake
Methodology
The study employs design-thinking- an iterative process to understand the barriers to COVID-19 testing and vaccine uptake. Then the flow of the process was as follows:
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Defining the problem
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Secondary research to identify themes for interviews that followed
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In-depth interviews with experts and general population
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Thematic analysis
Outcome
Developed a “Chawal-Dal-Achaar” framework to guide decision-makers by providing differentiated solutions that catered to the needs of the people:
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Chawal: base suggestions that are valid across different states, geographies, and demographics. For example, (i) Testing – Make provisions for affordable PoC and rapid testing with high sensitivity, and (ii) Vaccination – Disseminate information about the process of online and offline vaccination registration through official channels, newspaper advertisements, social media by providing clear steps with a flowchart
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Dal: essential suggestions that differ by state/region (urban/rural) due to political/ educational/ income/ cultural factors. For example (i) Testing – Provide mobile sample collection and testing vans at public places such as places of worship and outside malls, and (ii) Vaccination – Publicise information through local leaders about side-effects and efficacy highlighting how vaccination reduces the probability of severe COVID-19 and number of days of transmission
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Achaar: differentiated suggestions at a decentralized community level. For example, Scale-up decentralized programmes, such as Maharashtra's “Maajhe Kutumb, Maajhi Jabaabdaari” and Punjab’s “Corona Mukt Pind Abhiyaan” to enhance the sense of collective responsibility.