Improving Access to COVID-19 Testing in India through Systems Strengthening
Improving Access to COVID-19 Testing in India through Systems Strengthening
Year: November 2020
Collaborator: PATH and Rockefeller Foundation
Team: Pratima Jandhyala, Samriddhi. S. Gupte and Ashish Sachdeva
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
The study aimed 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 offered support to 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 aimed to:
- Understand the factors affecting uptake of COVID-19 testing and vaccination
- Outlining differentiated solutions to boost uptake
Methodology
This qualitative study used a design-thinking framework grounded in economics, behavioural sciences and psychology theories- Theory of Demand, Theory of Planned Behaviour and Health Belief Model using primary (through in-depth interviews with the general population and subject matter experts) and secondary methods. Following which, the thematic analysis of collected data was done.
Outcome
We developed a “Chawal-Dal-Achaar” framework to guide decision-makers by providing differentiated solutions that catered to the needs of the people:
- 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.
- 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.
- 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.