Ground Report: How ‘Har Ghar Dastak’ is Helping Most Backward Nuh District Get Vaccinated

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“Vaccines cause infertility”, “It’s an agenda to reduce population”, “Vaccines lead to death” — some of the many misconceptions Prime Minister Narendra Modi’s door-to-door vaccination campaign is tackling with in Nuh district of Haryana while it continues to aggressively run the Covid-19 vaccination programme in India’s most backward district.

Government data shows that ‘Har Ghar Dastak’ campaign has been able to boost coverage of Covid-19 first dose by 5.9% since its launch in November, whereas there has been an increase of 11.7% in the second dose coverage in India.

ASHA workers, who are the backbone of the initiative, have been implementing the mission on the ground debunking the myths after reportedly facing abuses, insults and curses. They start the inoculation drive around 9 am and visit more than 25 houses daily, at least 10 ASHA workers from the two districts told News18.com.

“’Jaan hai to Jahan hai’ (If you are alive and healthy, you have everything),” is the key message of ASHA workers to the public as they go door to door convincing people to get the vaccine shots as early as possible.

Dressed in red suits, these workers counsel people several times and visit their house until they administer the final dose. They have finally started reaping the results.

A workers speak to people several times to convince them until they administer the final dose of Covid-19 vaccine. Image credit: Himani Chandna/News18.com

While Rajasthan claims to have seen a spike in coverage by 8-10% since the launch of the scheme, Haryana says its numbers have shot up by 8% since the launch of the programme.

How Campaign Has Helped Vaccine Coverage

According to Dr Virender Ahlawat, State Immunisation Officer, National Health Mission, Haryana, “The push in the second dose is reasonably high. Earlier, our second dose coverage stood at 60%, it moved up to 80% recently.”

“Thanks to the initiative carried out by ASHA workers in the toughest districts,” he said while adding that the campaign caught hold of people who were delaying the second dose due to the carelessness or unavailability of time.

The door-to-door campaign has also helped those who were dependent on others to take them to the vaccination centres or who forgot to take their second jab, he explained.

While the vaccination coverage is going up, the state data shows that Nuh is the worst performing district of the state followed by Palwal and Jind.

Nuh, which has been ranked at the bottom of Niti Aayog’s 101 most backward districts of India, has around 35% of the target 10 lakh population vaccinated with the first dose while 7.9% have been administered two doses, as of November 5.

“Since the launch of the campaign, the statistics have improved to 62.92% for the first and 13.36% for the second dose. More than 27% increase in the first dose coverage, and 5.46% increase in second dose coverage has been noticed after launch of ‘Har Ghar Dastak’,” Dr Basant Dube, district immunisation and child health officer in Nuh, said.

News18.com travelled to Nuh to track the execution of the door-to-door vaccination drive on the ground. One of the 22 districts in Haryana, Nuh is a Muslim-dominated region while around 20% are Hindu inhabitants.

A group of ASHA workers, serving in different blocks of the district, told News18.com that they have seen a massive progress in acceptance of vaccination as compared to January when India had started the national vaccination drive.

Savita Jain, Kavita, Aarti Kumari and Santosh are aggressively trying to complete their vaccination target in each block. “No one was interested in getting the shots. In fact, no one wants to accept that there is an outbreak of Covid-19,” said Savita Jain, an ASHA worker for the last two decades, serving in Sakras block.

Jain said people believe Covid vaccines are a “conspiracy of the government to reduce population. “They raise questions over the effects of vaccines and say the vaccines given to Hindus are different from Muslims.” She even added that the villagers believe that these vaccines will make a certain community infertile.

Aarti Kumari, another ASHA worker in Nuh, recalled she would spend the entire day knocking on the door but no one would agree to take the vaccine dose. “In return, they would hurl abuse, curse our children and threaten to slap us if we visited them again.”

The three principles helping ASHA workers ace the campaign are – self-promotion, involving popular members from the community and creating a narrative that unvaccinated people will be barred from receiving essential services.

“We are promoting ourselves as brand endorsers in debunking the myths that vaccines kill or make one infertile. We are seeking help from well-known or respectable people of the religious groups to convince the households that they are difficult to crack,” said Santosh, ASHA worker in Ferozepur Jhirka.

“Kya kare? Inko inki bhaasha me samjhana padta hai (What to do now? They need to be told in their language),” she said in a disappointed tone and further explained that they have been unofficially informing the unvaccinated population that “they will not be able to enjoy the services given by the state government in the coming days including the distribution of ration, government jobs, pension, public transport and free fertilisers.”

Aarti, another worker who takes care of the vaccination drive in Dhoond Kala, filled with a sense of achievement, said, “I had convinced a family of 18 members who never even allowed immunisation of infants.”

Going by the National Family Health Survey data in 2015-16, only 13.1% of children were vaccinated under the immunisation plans as compared to 53.8% in 2020-21 though the hesitancy continues to date.

Her accomplishment to administer Covid-19 vaccine to the family which never even opted for infants’ immunisation sounds valid. “Sabne bola wahan mat jana… ghar walo ne mana kiya… Asha workers ne bola jayegi toh thappad kha ke aayegi.. Par mujhe jana tha…” (People told me not to go there. My colleagues told me that I will get a slap. But I wanted to do it.)

Aarti convinced her senior, a male colleague who belonged to the community of the same family, to accompany her.

“It took three visits to convince the family,” she said.

“Now, the situation is much better.” But how? “I took help of a retired Muslim army officer. He went with me door to door, sat on the vaccination booths and convinced Muslims to take the jabs by debunking their myths.”

Kaithal, another district in Haryana, which is among bottom five performers in the vaccination coverage, is also noticing improvement as the majority of population of farmers who were at the loggerheads with the Centre over the farm bills after taking the jab after the repeal of agrarian laws. “They were against the vaccination drive. Now, we are expecting that they will come forward and accept the jabs,” said Dr. Ashish Goel, district immunisation officer, Kaithal.

“Since the launch of the campaign, there has been a massive improvement as we are able to go door to door and convince people to get their dose. While in November, our first dose coverage stood at 73% which has now increased to 81%, whereas the second dose stood at 32% last month that has now moved 46%.”

Rajasthan’s Alwar Fixing Alcoholics, Rumour Mongers

The data on CoWin shows that the coverage of the first dose in Alwar stands at more than 60% and over 40% for the second dose.

“There is no community-based hesitancy as such in this area due to the literate population. The major problem is among the group of alcoholics or some people who have heart ailments. They get affected by the rumours and link the natural or coincidental deaths to the side-effects of the vaccine,” said Veermati Yadav, auxiliary nurse midwife, in Bas Kirpal Nagar, a village in Kishangarh Bas Tehsil in Alwar District.

The ASHA workers have been trying to convince around 11 people in one go during the door-to-door drive to reduce the wastage of vaccines. “As we are able to convince 11 people, we can open the vial of Covishield without wasting any dose,” Yadav said.

According to Anuj Sharma, Block Program Manager at Kishangarh Bass, Alwar, the area has achieved 10% vaccination coverage under the campaign in last one-and-a-half month.

The community health centre at Kishangarh Bass. (Himani Chandna/News18.com)

Another worker, who refused to be named, said while the drive has been increasing the coverage of vaccines, it has been a burden on tired ASHA workers.

“We need to make an online registry followed by a register entry. Then, we need to open the vial by taking care of all protocols and finally administer the dose,” she said. This is done after they succeed in convincing the families, she added.

According to Dr Arvind Gait, reproductive and child health officer (RCHO), Rajasthan, the next target of the scheme is to capture people who leave for work early in the morning.

Also, the state has informed traffic police officers, ration shopkeepers and public transport managers to ask for vaccination certificates. “They won’t harass the public, but asking for the same will make the public serious about getting the jabs as soon as possible.”

“The industrial areas including Bhiwadi, Neemrana, Alwar and Behraud have been identified where we are vaccinating people. As soon as they leave from work, they are administered on the way back home,” Gait said.

People such as slum dwellers who don’t have their identity proofs are also being vaccinated, he added.

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