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Making COVID vaccines accessible for all

Rakt Rohaniya, a village of Sono Block of Jamui is one of the least vaccinated villages under the RECOVER-Bihar project. It has a population of more than 2500 residents across three hamlets – Rakt Rohaniya, Ravidas tola and Muslim tola. The demography includes a mix of Muslims and Hindu Scheduled Caste.

Situated at a distance of 15 kilometers (approx) from the Sono block headquarter, Rakt Rohaniya is a hard-to-reach region. It takes a walk of 5-6 kilometers to reach Pachpahari, where public transport is available, which makes accessing healthcare or any other service a massive challenge. The nearest market of Jhajha is also about 6-7 KM away. The residents are mostly employed in the Bidi rolling (Tobacco) industry or work as daily wage laborers in nearby markets and construction sites. A good portion of the workforce are migrant laborers.

The Muslim tola mostly has concrete houses, while Ravidas tola has mud and kachcha houses. The whole block is far behind in education and other human development indexes. To facilitate mobilization here, the block coordinator (BC) appointed three Village Mobilization Coordinators (VMC). The VMCs under the supervision of BC carried out line listing and discovered the Muslim and SC sections were largely unvaccinated with about 56 refusals in the Muslim tola and 43 refusals among the Schedule caste population.

While the VMCs were able to convert refusals within the schedule caste population through preliminary house visits and counselling, it did not seem to work for the Muslim tola. The block and district coordinators decided to expand the mobilization network by engaging newly elected Panchayati Raj Insitution Members, religious leaders from the Muslim community, ASHA and AWW workers in the village.

The mobilization team found maximum refusals in people having comorbidities, pregnant and lactating women and some people who feared the after effects of the vaccine. The ground team identified Dr. Parwaz as a trusted and influential source among the villagers. Being a philanthropist, he had previously conducted free medical camps in the past.

After line listing and preliminary visits throughout the block, PCI ground team liaised with the CHC and planned a vaccination session on January 13th, 2022. Dr. Parwaz had mobilized his team on the session day and organized a full-fledged health check-up camp in Rakt Rohaniya with free medicine distribution. On the other hand, the ground team liaised with a Maulvi from the local mosque and arranged for announcements through the PA system from the mosque,
encouraging people to get vaccinated.

The free health checkup camps led by a trusted doctor encouraged people to visit the camp, the presence of Maulvi helped build trust in people facilitating smoother mobilization for COVID-19 vaccine. When the footfall at the session site reduced, the ground team along with the doctor decided to switch onto a door-to-door approach. The line listing done by VMC helped identify the houses with refusals and the availability of demographic profiles of people, helped the team to pace their efforts around building strategies to break refusals.

The team was also able to reach people with low mobility. A total of 68 beneficiaries were vaccinated through this endeavor; 35 were first dose recipients and 33 second dose recipients. Out of the total vaccinated, there were 12 cases of converted refusals, 4 pregnant, 5 lactating women, 13 elderly and 01 differently-abled.

To acknowledge the beneficiaries who had taken vaccination and encourage others to participate, the RECOVER team conducted a lucky draw and felicitated 15 people of the 68 beneficiaries. The team gathered some of the unvaccinated people in the village common area and explained the importance of vaccination to them. The day ended after the unvaccinated people took a pledge to take the vaccine during the next session and make Rakt Rohaniya a
village with 100% vaccination coverage.

The vaccination effort in Rakt Rohaniya is a testament to the benefits of understanding the community issues before beginning the mobilization process. Identifying and addressing community concerns and offering positive motivations helps trust building. Simultaneously, leveraging trusted community influencers and working in an embedded manner with the State and religious belief systems is critical to achieve a successful vaccination drive. There is a long way to go before achieving the 100% vaccination target; however the team’s empathetic approach towards the community and strategic partnerships will certainly yield the intended results.