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Covering the last leg one-step at a time
Through RECOVER Bihar project we ensure no one falls through the cracks: A homeless elderly getting vaccinated in Rajandipur village, Bhagalpur.

In the Sabour block of Bhagalpur district lies Rajandipur, a village situated on the banks of the river Ganges. Nine kilometers from the Bhagalpur district headquarters, Rajandipur is one of the villages under the RECOVER Bihar project. The main occupation is farming and daily wage labor. While men go out to work, women mostly stay at home and engage in animal husbandry. With a total population of 1785, the village is divided into eight wards. One of the wards in the village is Santnagar, mainly occupied by the Mandal caste community. A muddy and rocky patch of land separates the 747 residents of Santnagar from the rest of the village.

When the Project Concern International (PCI) team first visited Rajandipur, it was discovered that Santnagar was an area where the COVID vaccination efforts hadn’t reached yet. The difficulty to cross the rough patch had kept the residents away from mobilization efforts and limited their access to vaccines and medication. Also, the flooding during rains led to seasonal migration, cutting the Santnagar residents from the State services.

As the PCI team began the intervention, the first step was to build trust with the community. Therefore, two VMCs from Rajandipur were recruited with the help of Jeevika and inputs from the ward members. While the PCI team didn’t face much of a challenge counseling and reaching out to the other seven wards; Santnagar posed quite a challenge as even the RI hasn’t penetrated in the community. As a result, the PCI team leveraged the help of a trusted village Anganwadi Worker (AWW) to strike the initial conversation while VMC prepared the line-list. 

Getting beneficiary details for line listing had its own challenges. It was difficult to get identity information from the men who left their houses for work at 5 am in the morning or encourage the women to take vaccination without consulting their guardians. As a solution to this, the PCI team with the help of VMC and ASHA asked the women to hold on to the ID cards of all family members so the team could come the following day to gather relevant information. Such planning as per the situation helped the team collect information in a timely and resourceful manner.

The RECOVER Bihar project tries to leverage the existing system at every step of the way to ensure optimal support can be provided to the State vaccination efforts. Hence, to make vaccination accessible to Santnagar residents, the PCI team requested the Medical Officer In-charge (MOIC) and the Block Health Manager (BHM) to provide them with an ANM who is active and able to cross the rough patch to Santnagar ward.

Hesitant elderly women agreed to take vaccination post counseling as she was afraid of needles and side effects. The team told the women they would wait for 30 minutes post vaccination to make sure she is okay. Once reassured, she agreed to take the vaccine

Besides successfully organizing the first vaccination camp in Santnagar, the PCI team has till date successfully set up 5 vaccination session sites in other wards of Rajandipur. And the numbers speak for themselves. Before PCI’s intervention, within the 18+ category, 97 were due for the first dose, and 237 were due for the second. Post PCI’s intervention, 88 who were due for the first dose, and 236 due for the second dose have been vaccinated. Even within the 15-18 age group; out of the 132 due for the first dose, 108 have been vaccinated, and out of the 132 due for the second dose, a total of 32 have been vaccinated.

Gradually with the help of the human-centered mobilization tools designed by PCI project partner Vihara Innovation Network, the VMCs were able to apply empathy driven counseling approaches. The leaflet guide to targeted counseling has a QR code. When scanned, it opens a link to videos of beneficiaries from different special groups such as elderly, pregnant, chronically ill, and the like. This was an effective tool for VMCs to encourage vaccination uptake by addressing group specific concerns. Additionally, the trusted local elders and ward members who were convinced about the importance of vaccination were also requested by the PCI team to join the mobilization efforts. For some of the beneficiaries the ‘wait and see’ approach worked. As they witnessed other members of the community get vaccinated, they also came around.

Vaccinated Beneficiaries of Santnagar from 15- 18 and 18+ age groups provided with certificate printouts post vaccination.

For the RECOVER Bihar team, it is not only about the numbers, but also about the vaccination experience and ensuring that the beneficiaries feel heard and valued throughout the process. Therefore, to acknowledge steps taken in the direction of safe and healthy living, all those who were vaccinated were given certificates. The team continues to break refusal and reach difficult pockets to achieve the last leg milestones through 100% vaccination coverage.
We appreciate the commendable efforts of Md. Rashid (District Coordinator), Tarique Ahmed (Block Coordinator), Guru Datt (Verifier), Nitish Kumar and Soni Kumari (Village Mobilization Coordinators), Rina Sinha (Auxiliary Nurse Midwife), Vibha Devi (Anganwadi worker), Vinay Kumar Upadhay (Block Health Manager) and Dr. Subhra Verma (Medical Officer In-Charge) for bringing this village one step closer to 100% vaccination.