Two big gaps in our vaccination programme that need attention

Source: Live Mint

Synopsis: India’s Capacity to vaccinate has been constrained by many factors. India needs to address those factors to improve its fight against the Pandemic.

Background

India’s vaccination programme has been hampered by a short supply of vaccines and this has dominated the public discourse.

However, there are two other equally important matters that have been given insufficient attention

  • First, the capacity of our health system to vaccinate people.
  • Second, public demand for vaccination, including the issue of vaccine hesitancy.
Issues in increasing Vaccination capacity

One, given the vaccine shortage, state governments responsible for vaccination have been preoccupied with procuring doses rather than focusing on their capacity to vaccinate on-demand

Two, the matter of capacity is currently plagued by oversimplification and lack of nuance.

Issues that determine our effective capacity.
  • First, the capacity of India’s Subcentres.
    • The public health system’s facility closest to villages is called a ‘subcentre’. It is an extension of a PHC, or primary health centre.
    • Each subcentre is supposed to serve a population of 5,000. India has over 150,000 subcentres.
    • Though PHC is the first point of in-patient care and access to a doctor for most people, subcentres hold the key to any vaccination programme. Because
      • One, they are closest to habitations and designed to be staffed with people trained to give intramuscular injections, among other things.
      • Two, the capacity can only be determined by details at the sub-centre level. That is the actual presence of trained personnel, refrigeration facilities at the PHC and sufficiency of ice boxes for distribution to subcentres, etc.,
    • Second, the data entry requirements for Covid are a very much needed task. However, poor internet connectivity across the country increases the cycle time for data entry. They deprive health personnel of significant time, reducing capacity.
    • Third, Problems with the basic operating model in many places. India follows a ‘people-to-vaccine model’. where people are expected to come to Subcentres. An alternate model, a ‘vaccine-to-people model’, where the subcentre staff go to villages or mohallas and hold vaccination camps can increase capacity.
    • Fourth, Public demand for vaccination needs to be increased by nudging people to give up ‘Vaccine hesitancy’.
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