By Santanu Mishra India can never get over the devastating losses incurred because of the second wave of Covid-19 that overwhelmed the entire health system. People were struggling to find hospital beds and medical supplies- which became scarce and exorbitantly priced. Many perished due to overburdened healthcare facilities. The losses engulfed the entire human race at multiple levels, including emotionally and financially.

Although the second wave primarily affected cities, tremors were also felt in rural India. Rural areas in states such as Madhya Pradesh, Maharashtra, Rajasthan, and Jharkhand contributed to a steep rise in the number of active and positive cases across India and subsequent deaths.

Experts believe vaccination along with the use of masks, hand-washing and social distancing is the way out of the pandemic. However, in many parts of India, in particular rural areas, vaccine indecisiveness coupled with a general lack of healthcare facilities have contributed to a surge in case fatality.

Misleading information and rumours like “5G causes corona”, “Government declaring people Covid-positive even if they are not”, spread by word-of-mouth made it challenging to control and combat the spread of the virus. This deceptive information played a devastating role especially in the villages that anyways have a dearth of reliable sources of information.

Multiple states and central government-sponsored surveys which assessed misrepresentation of facts about Covid-19 in rural areas have revealed that a large number of people believe vaccination could be life-threatening as the vaccines have become available in the market in a very short time thereby compromising on ethical and quality compliances. Studies and surveys have also highlighted that a large section of the population considered forwarded messages on Social Media Platforms as reliable sources of information.

We need to resolutely tackle the twin concern towards lack of awareness and spread of deceptive information among masses– both in urban and rural areas. This requires a multi-pronged strategy comprising effective planning, sustained counselling, and combating the spread of rumours. There is a need to emphasise and bring about assurance and trust about the importance of getting vaccinated.

Research shows that there are five established categories of adopters to change, and while a majority of the general population tends to fall in the middle categories, it is still necessary to understand the characteristics of the target population. These are:

a) Innovators –people who want to be the first to try the innovation

b) Early Adopters –those who represent opinion leaders, enjoy leadership roles and embrace change opportunities

c) Early Majority -people who are rarely leaders, but they do adopt new ideas before the average person. They typically need to see evidence that the innovation works before they adopt it

d) Late Majority – sceptics of change, adopt only after innovation has been tried by the majority

e) Laggards – people bound by tradition, very sceptical of change, and the hardest group to bring on board.

While promoting an innovation like vaccines, it is to be understood that there are different strategies to be used to appeal to people from different adopter categories. Through continuous and sustained efforts, civil society organisations like Smile Foundation have worked with people in the early majority and late majority groups particularly among underserved communities to help them overcome their perceived barriers and get inoculated.

As of now, not only vaccine uncertainty, even the identification of Covid-19 cases appear to be a huge obstacle for health workers as people are often treating the virus-like common cold and flu. Getting frontline health workers to do regular household-to-household monitoring will help in the identification of positive cases and effective management & treatment.

A survey conducted by Smile Foundation, across Delhi, Haryana, Uttar Pradesh, Telangana, Tamil Nadu, Chhattisgarh, Gujarat, Maharashtra, Karnataka, West Bengal, Jharkhand, and Rajasthan via telephonic interviews in regional languages, among 27,216 respondents found that almost one in four Indians is unable to protect themselves completely from getting infected. While 22.7 percent of respondents said they visited private hospitals or clinics for primary healthcare services, about 45 percent relied completely on PHCs/CHCs.

Rural Health Statistics (RHS 2019-2020) found there are only 24,918 Primary Health Centres (PHCs), 155,404 rural sub-centres (SCs), and 5,183 Community Health Centres (CHCs).

The problem is deep-rooted and lies in the inaccessibility of these PHCs and CHCs. In some cases, these centres are quite far from the villages because of which people are deprived of proper healthcare facilities and accurate information. Additionally, these healthcare centres are ill-equipped to handle and cure even basic illnesses.

o fulfil their needs, Smile Foundation initiated the HealthCannotWait campaign. The campaign includes multi-pronged initiatives which aim to provide healthcare services to the larger community, a telae-counselling service for the underprivileged aimed at providing emotional and psychological support, and online telemedicine service through e-clinics.

We at Smile believe that there needs to be a very strong collaboration between Panchayats and community leaders in villages with NGOs and health workers to generate awareness and to upgrade healthcare centres. When lives are threatened due to lack of information and misinformation, clear communication is key.

Community leaders and local influencers must be roped in to effectively weed out untruths about vaccination. People must understand that the virus cannot be tackled with doubt or denial. Getting tested and vaccinated is the only way to stop Covid-19 from spreading.

•By Santanu Mishra, Co-Founder and Executive Trustee, Smile Foundation (DISCLAIMER: The views expressed are solely of the author and ETHealthworld.com does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly.)