Table 3.
Critical problems, intervention, and impact.
| Problems and issues | VOW intervention | Impact | |
|---|---|---|---|
| Tier-I | Hesitancy in slum areas | The VOW team and local municipal leaders resolved any hesitancy related to vaccination. | More people were willing to take the vaccine. |
| Difficulty vaccinating specific populations (migrant workers, sex workers, transgender people etc.) | The VOW team reached their door-step to make them comfortable, as they hesitated to go to the vaccination camps | A more significant number of marginalized populations was covered. | |
| Difficulty in mobilizing beneficiaries | The team conducted awareness programs, and beneficiaries were given counseling. | People were impacted positively, and the number of vaccinated people grew slowly. | |
| Server issues | During server issues, data regarding vaccination was registered physically | Physically registered data was uploaded by the VOW personnel once the server resumed, thereby no data was missed | |
| Rumors about vaccine adverse effects | Any doubts about the vaccine's post-effects were communicated to the beneficiaries. | People were more confident regarding the COVID-19 vaccine | |
| Tier-II | Mobilization issues | The VOW team and ASHA workers went door to door to mobilize the population | A more significant number of people were vaccinated. |
| Scheduling issues (Clash of session timings with working hours of beneficiaries) | The VOW team visited the beneficiaries in the early morning and late evening hours per their availability. | It led to more excellent coverage and an assurance that no one would be left behind. | |
| Hesitancy caused by false information about vaccines | Proper counseling sessions were taken place to remove any hesitancy | Beneficiaries were more confident, and gradually the rumors were removed | |
| Network issues (Data entry on Cowin portal) | If the server was down, the data entry operator physically registered the beneficiaries' details. | Physically collected data was eventually uploaded once the server resumed | |
| Rural/Tribal | Unavailability of beneficiaries (daily wage workers) | Early morning and late evening sessions were arranged to vaccinate the beneficiaries | This made it convenient for the local people to get vaccinated |
| High vaccine reluctancy | Community engagement (Panchayat leaders, religious heads, schoolteachers) | Local leaders had a more significant impact on the local population, and it led to higher coverage | |
| Low health literacy | Appropriate IEC strategies were employed to educate rural people | People were more aware and educated regarding the vaccination | |
| Low reachability | Van and other vehicles were used. | Since the rural area terrain is challenging to reach, VOW ensured more excellent coverage by reaching their door-step | |
| Population is scattered | Gathered the beneficiaries at a commonplace in their region | Small pockets where people were less in number were vaccinated at their convenience | |
| Transportation issues (Poor roads and infrastructure) | Avoided rainy days to travel; Departed early to reach the vaccination site on time | VOW team was prompt to address such issues and planned accordingly; thus, reachability increased |