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Pitfalls of leveraging Common Service Centers for rural vaccine drive

In a recently affidavit to the Supreme Court, the Central government recently appeared to have taken cognisance of the digital divide in the country and said that registration for vaccines will be done through Common Service Centres (CSC) in rural areas. As a result of this decision, the government effectively could create National Health IDs, as part of the National Digital Health Mission, en masse through these centres which historically have been enrolment points for various government initiatives including the Aadhaar project.

CSCs’ are IT Ministry physical centres spread across the country to provide public utility services, social welfare schemes, healthcare, financial, education and agriculture services to citizens without direct access to such services.

In the affidavit, the Centre said that much of India lives in rural areas which which are governed by local self-governments at grassroots levels like Panchayats. “After the country entered the digital era, almost all these gram panchayats have established common service centres which have a digital platform to be used by the people. This CSCs and its (sic) infrastructure is widely and effectively used in rural areas for various purposes and is found to be an effective module taking the development to the grass root levels. This provides access to the internet to a vast variety of persons who may not be adept in using it or may not have direct access to it.”

However, this move still ignores the existing vaccine distribution infrastructure that the country has in place and instead insists on relying on tech-driven steps which may still well prove to be difficult to access for those on the other side of the digital divide.

‘Make use of country’s existing health infra’

This is not the first time the country is seeing a mass vaccination drive. India has successfully dealt with diseases such as polio and so on through a through drive that involved the grassroots as well the bureaucracy. Several leaders have come forward and urged the government to make use of this available infrastructure, rather than insisting on exclusionary tech, for this current ongoing vaccination drive.

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In a recent letter to Prime Minister Narendra Modi, Rajya Sabha MP Mallikarjun Kharge said, “Finally over the past 70 years, India has built up a robust healthcare system consisting of hospitals, community health care centres, primary healthcare centres, clinics.. and has a vast network of community health workers. India undoubtedly has the bandwidth and the resources to effectively combat the pandemic. However, to do so, the union government must leverage our collective strengths by governing consensually and inclusively.” MediaNama has seen a copy of the letter.

The government’s vaccine policy is a tech-driven policy, which is why it is relying on CSCs to register citizens onto the Co-WIN platform. It is important to remember that CSCs were an integral part of the Aadhaar project, as these centres were used to enroll a significant proportion of the population onto the national health ID.

Mass enrollment for National Digital Health IDs

The assistance on Common Service Centres for rural population despite the myriad difficulties translates into a ramp-up of the government’s plan to create a National Health ID for citizens by hitching a ride on India’s vaccine rollout —while the Co-WIN platform authenticates your Aadhaar, the vaccinate results will be issued through a freshly created National Health ID.

Last year Prime Minister Narendra Modi had said , “India is already working on putting a well-established vaccine delivery system in place. This digitised network along with digital health ID will be used to ensure immunisation [for COVID-19] of our citizens.” The rollout is already under way in Union Territories and as on September 2020, around 1 lakh health ID were issued.

13,000 GPs do not have a CSC

The Centre’s affidavit mentions that ‘almost all gram panchayats’ have CSCs, which means that there are certain gram panchayats in the country where there are no CSCs. For citizens of these gram panchayats, getting registered on the CoWIN portal would mean traveling to their neighbouring village in the middle of this deadly second wave of the pandemic in search of a CSC.

According to the CSC Annual Report 2019-2020 said there were 2.53 lakh gram panchayats in the country as of March 31, 2020, of which CSCs were present in 2.40 lakh panchayats. This means that around 13,000 gram panchayats in the country do not have such a centre.

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The total number of operational CSCs increased to 3,60,873 CSCs as against 3,45,246 operational CSCs in the previous year, while at the Gram Panchayat level there also was a substantial increase in the number of operational CSCs o 2,68,385 CSCs at the end of March 2020 from 2,28,547 CSCs in March 2019, said Ajay Prakash Sawhney, chairman of the CSC e-Governance Services India Ltd.

City-zens opting for rural centres for vaccination

It is fast proving to be difficult and in the coming days, going to be more cumbersome for rural citizens to get their vaccine slot registered in their local centres. That is because city dwellers who have been frustrated for months due to the unavailability of vaccines and slots are shifting to the hinterlands for their jabs.

A similar case was documented by The Hindu in Maharashtra where local citizens in the Narayangaon village in Pune were finding it hard to get a slot in their nearby vaccination center. The article quotes Pune Zilla PArishad Chief Executive Officer Ayush Prasad saying, “Things were fine when people from the rural parts were getting their first doses, which were mainly through walk-ins. At the time, rural representatives were proactive in ensuring that citizens here, especially the elderly, received their jabs on time. Online registration has, in fact, made matters worse, especially vaccination for the 18-44 years age group. As a result, if people in the urban parts are not getting slots there, they are booking or rushing to get their doses here.”

Independent security researcher Srinivas Kodali who has been raising his voice on the ground for a vaccine policy that is less dependent on technology, said, “CSCs won’t be helpful unless the centre is allocating slots specifically for rural population which can only be booked with CSCs. With no such reserved slots, urban youth are registering them faster on their computers and even taking away rural slots.”

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Among other subjects, I cover the increasing usage of emerging technologies, especially for surveillance in India

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