Health Promotion International, 2021;36:1716–1726
doi: 10.1093/heapro/daab050
Advance Access Publication Date: 18 May 2021
Article
The first 100 days: how has COVID-19 affected
poor and vulnerable groups in India?
1
Centre de recherche du CHUM (CRCHUM), Montréal, Québec H2X 0A9, Canada, 2Département de gestion, d’évaluation, et de politique de santé, École de santé publique de l’Université de Montréal (ÉSPUM),
3-7101 Av du Parc, Montréal QC H3N 1X9, Canada, 3Department of Electrical Engineering, Indian Institute
of Technology Delhi, Block II, IIT Delhi Main Rd, IIT Campus, Hauz Khas, New Delhi 110016, India, 4School
of Information Technology, Indian Institute of Technology, Delhi Hauz Khas, New Delhi 110 016, India,
5
Gram Vaani Community Media (Onion Dev Technologies Pvt. Ltd.), Plot No. 2, First Floor, 100 Feet Road
Ghitorni, MG Road, New Delhi 110030 India, 6Raah Health and Social Development Foundation, Kh.No 54/
1, Street No-6, Block- A, Parasram Enclave, Burari, New Delhi 110084, India and 7Department of Computer
Science and Engineering Block IIA, Bharti Building Indian Institute of Technology Delhi Hauz Khas, New
Delhi 110 016, India
*Corresponding author. E-mail: aseth@gramvaani.org; covid-response@gramvaani.org
Summary
In India, strict public health measures to suppress COVID-19 transmission and reduce burden have
been rapidly adopted. Pandemic containment and confinement measures impact societies and economies; their costs and benefits must be assessed holistically. This study provides an evolving portrait
of the health, economic and social consequences of the COVID-19 pandemic on vulnerable populations in India. Our analysis focuses on 100 days early in the pandemic from 13 March to 20 June 2020.
We developed a conceptual framework based on the human right to health and the UN Sustainable
Development Goals (SDGs). We analysed people’s experiences recorded and shared via mobile
phone on the voice platforms operated by the Gram Vaani COVID-19 response network, a service for
rural and low-income populations now being deployed to support India’s COVID-19 response.
Quantitative and visual methods were used to summarize key features of the data and explore relationships between factors. In its first 100 days, the platform logged over 1.15 million phone calls, of
which 793 350 (69%) were outbound calls related largely to health promotion in the context of COVID19. Analysis of 6636 audio recordings by network users revealed struggles to secure the basic necessities of survival, including food (48%), cash (17%), transportation (10%) and employment or livelihoods
(8%). Themes were mapped to shortfalls in 10 SDGs and their associated targets. Pre-existing development deficits and weak social safety nets are driving vulnerability during the COVID-19 crisis. For
an effective pandemic response and recovery, these must be addressed through inclusive policy design and institutional reforms.
Key words: COVID-19, mHealth, social determinants of health, right to health, social justice
C The Author(s) 2021. Published by Oxford University Press. All rights reserved.
V
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Mira Johri 1,2, Sumeet Agarwal3,4, Aman Khullar5, Dinesh Chandra6,
Vijay Sai Pratap5, and Aaditeshwar Seth4,5,7,*; the Gram Vaani Team5
The first 100 days
INTRODUCTION
understand how the COVID-19 pandemic and mitigation strategies have affected poor and vulnerable groups
in India. Due to a range of factors, including generally
weaker health systems and lesser fiscal space [commonly
defined as the budgetary flexibility that allows a government to provide resources for public aims without
undermining fiscal sustainability (World Health
Organization, 2021)], developing country governments
confronting the pandemic are faced with extremely difficult choices. While COVID-19 disease is inflicting substantial human costs, public health protection measures
to suppress transmission and reduce burden severely impact societies and economies (https://www.cgdev.org/
blog/resilience-developing-nations Accessed March 06,
2021). It is important to assess the costs and benefits of
these measures holistically. This work thus has two
aims: (i) to provide an evolving portrait of the health,
economic and social consequences of the COVID-19
pandemic on vulnerable populations in India, based on
the perspective of the human right to health and the
Sustainable Development Goals (SDGs) and (ii) to draw
policy lessons to inform a resilient pandemic response
and support an inclusive recovery.
Our analysis focuses on 100 days early in the pandemic, from 13 March, 12 days before the national lockdown when India had 91 confirmed cases, to 20 June,
12 days after the national lockdown ended, when the cumulative case count stood at 426 901 (https://www.covi
d19india.org/ Accessed July 25, 2020). As of 20 June
2020, the Gram Vaani COVID-19 response network included 26þ civil society partner organizations across 10
states and 80þ districts, and had logged over 1 million
phone calls and 18 000 user-recorded messages. These
are the voices of the poor.
METHODS
Context
Several characteristics make India vulnerable to the
effects of COVID-19 and related mitigation measures.
Overall economic growth has been strong in recent
years, with extreme poverty (US $1.90 per day) dropping from 46% in 1995 to an estimated 15.4% in 2015
(World Bank, 2020). Nonetheless, vulnerability to poverty persists for a large majority of the Indian population; 68% work for US $3.20 or less per day, the World
Bank’s new international poverty line for lower-middleincome countries (Kovacevic and Jahic, 2020).
The past decades have also witnessed important
reductions in disease burden accompanied by a rapid
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The global COVID-19 pandemic is a complex emergency with multidimensional consequences impacting
health, economies and societies. These consequences
threaten global development trajectories and are
expected to be particularly severe for poor countries and
people, especially in sub-Saharan Africa and South Asia
(World Bank, 2020). According to the World Bank’s latest estimates of the impact of COVID-19 on global poverty, COVID-19 will push 71–100 million people into
extreme poverty (<US $1.90 per day), mostly in subSaharan Africa, and propel an additional 176–231 million to join the ranks of the poor (calculated at <US
$3.20 per day), mostly in South Asia (World Bank,
2020).
A lower-middle-income South Asian country with a
population of 1.34 billion, India is the world’s largest
democracy. India’s first COVID-19 case was reported
on 30 January 2020; by March 11, the date that WHO
declared COVID-19 a pandemic, India had 71 confirmed cases. On 25 March, with 497 cumulative cases,
in an effort to contain the epidemic and avert a looming
crisis, the Government of India introduced a nationwide
lockdown (https://www.covid19india.org/ Accessed
March 06, 2021).
In parallel, Indian civil society organizations were
mobilizing to support the emergency. Used by rural and
low-income populations, Gram Vaani is a federated network of voice-based community media platforms now
being deployed to support India’s COVID-19 response
(https://gramvaani.org/?p=3631 Accessed May 10,
2021). The Gram Vaani COVID-19 response network
uses mobile phone technology and a network of groundlevel field partners to build awareness, counter misinformation, enable community feedback, and to link those
in need (e.g. of food, shelter, transportation, health care)
or facing injustice, to critical services. The platform can
be accessed using any simple mobile phone. Users can
listen to audio recordings and also record their own
voice messages, which after a moderation process are
published on the platform for other users to listen to.
This voice-based approach makes it suitable for less literate populations to participate, access useful information, record their own messages asking for help or
simply narrate their own experiences to share with other
community members. All services are offered free of
charge to end-users.
Based on people’s experiences recorded and shared
on the voice platforms operated by the Gram Vaani
COVID-19 response network, this article seeks to better
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M. Johri et al.
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Conceptual framework
We developed a conceptual framework to monitor the
effects of the COVID-19 pandemic and response measures based on the human right to health and the UN
2030 SDGs (Supplementary Figure S1) (Sustainable
Development
Goals:
Sustainable
Development
Knowledge Platform, 2020). The World Health
Organization recommends addressing human rights as a
key part of the COVID-19 response (World Health
Organization Special Programme for Research
Development and Research Training in Human
Reproduction, 2020). The human right to health is recognized by law in India (Constitution of India, 1950;
Dhar, 2012; Das, 2013; Mathiharan) and internationally. India was a signatory to the Universal Declaration
of Human Rights (UDHR), 1948. The Indian constitution, which came into force in 1950, was highly influenced by the UDHR and affirms the population’s right
to the highest standard of physical and mental health as
well as to protection of life and personal liberty and the
right to live with human dignity (Constitution of India,
1950; Dhar, 2012). In 1979, India also ratified the
International Covenant on Civil and Political Rights and
the International Covenant on Economic, Social and
Cultural Rights (Mathiharan). Through its progressive
interpretation of the Constitution, the Supreme Court of
India has effectively included the right to health as an integral part of the right to life (Article 21), which is a fundamental right (Das, 2013). The Supreme Court has also
upheld the importance of providing the key determinants necessary for realizing the right to health (Das,
2013), and recognizes a constitutional obligation to provide health facilities, services and timely access to treatment (Das, 2013; Mathiharan). Unanimously adopted in
2015 by the 193 United Nations Member States, including India, the 17 SDGs provide a global blueprint to end
poverty, protect the planet and improve the lives and
prospects of everyone, everywhere (United Nations,
2015, 2016).
Categories described entitlements and determinants
enshrined in the right to health (The Right to Health.
Fact sheet no. 31, 2008) and were refined using a social
determinants lens (Working Group for Monitoring
Action on the Social Determinants of Health, 2018).
The final categorization was mapped to the UN SDG
Development
Goals:
framework
(Sustainable
Sustainable Development Knowledge Platform, 2020).
Data source
All data came from the Gram Vaani Interactive Voice
Response (IVR) system, which automatically logs all
outgoing calls and incoming contributions to the
COVID-19 response network platform. IVR data
stripped of personal identifying information can be disaggregated by various fields including user phone number, date, time, frequency, duration (s), type (outgoing
or inbound), content type (e.g. self-assessment of
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epidemiological transition; in 2016 all states had a
higher burden of disease due to non-communicable diseases and injuries than due to communicable, maternal,
neonatal and nutritional conditions (India State-Level
Disease Burden Initiative Collaborators, 2017).
Population ageing (8% of Indians are over age 65)
(Office of the Registrar General and Census
Commissioner, 2014) and the high disease burden due
to non-communicable diseases may place many Indians
at risk of negative outcomes due to SARS-CoV-2 infection. In 2016, the top 20 causes of DALY loss included
several known risk factors for severe COVID-19: ischaemic heart disease, chronic obstructive pulmonary disease, cerebrovascular disease, diabetes and chronic
kidney disease (India State-Level Disease Burden
Initiative Collaborators, 2017). Progress is uneven.
Diseases of poverty—for which the relationship to
COVID-19 risks is less well understood—such as nutritional deficiencies, diarrhoea, lower respiratory tract
infections, tuberculosis and other infectious diseases, remain predominant in some geographies and subpopulations (India State-Level Disease Burden Initiative
Collaborators, 2017).
Vulnerability due to structural inequalities, including
socioeconomic and demographic factors, health and hygiene conditions is also a key contributing risk (Acharya
and Porwal, 2020). Moreover, health system preparedness and response is a critical concern. While countries
with high scores on the United Nations Development
Program (UNDP) human development index have on
average 28.2 doctors, 56 nurses or midwives and 35 hospital beds per 10 000 people, India has only 7.8 doctors,
21 nurses or midwives and 7 hospital beds per 10 000
people (Kovacevic and Jahic, 2020). Compounding
problems of limited access to healthcare facilities, in
India, health insurance coverage is low and out-ofpocket expenditures are high, ensnaring many citizens in
a medical poverty trap (https://www.who.int/gho/coun
tries/ind/country_profiles/en/).
Against this backdrop, India’s public health response
to COVID-19 response has been decisive. The Oxford
COVID-19 Government Response Tracker gave India’s
measures to control the pandemic a stringency score of
100 (out of 100) (Hale et al., 2020).
The first 100 days
COVID-19 status, information and awareness, news, entertainment,
grievances,
interviews)
and
user
characteristics.
Data processing for the analysis of user
contributions
Variables
We analysed awareness-related content developed by
the Gram Vaani COVID-19 response network partners,
termed studio-generated content (SGC), using the continuous metric ‘minutes heard’ to track the outreach
achieved by this authoritatively developed content. To
analyse user-generated contributions (UGC), we took
two approaches: (i) we summarized the raw data and (ii)
we recoded data to represent the UN 2030 SDGs. To
construct the SDG variables, two authors (D.C. and
M.J.) mapped each relevant variable in the coding template to at most one SDG category (Supplementary
Table S2). To represent SDG5 (gender equality), we repeated analyses stratifying on caller gender.
Statistical methods
We used quantitative (counts, frequencies, proportions)
and visual methods to summarize key features of the
data and explore relationships between factors. Data
visualizations were programmed in Python using the
Folium and Plotly data visualization libraries and refined using Draw.io software. Location coordinates
were generated using Map My India’s geocoding library.
Analyses focused on the first 100 days of operation.
RESULTS
Total activity logged by the COVID-19 IVR
platform
In the 100 days from 13 March to 20 June 2020, the
COVID-19 IVR platform logged 1 153 249 total interactions linked to 917 587 unique phone numbers (callers).
Of this total, 793 350 were outbound calls offering SGC
related to COVID-19 information, awareness-building
and service linkages and 359 899 were incoming calls
made by users to the IVR platform. These incoming calls
led to 19 832 recorded UGC. An SOS functionality enabled callers to signal situations of extreme distress or
danger; fully 4931 (24.86%) of user contributions were
SOS messages, most of which were followed-up by the
Gram Vaani COVID-19 response network to provide relief assistance to the people. Figure 1 shows the spatial
distribution of contributions within India; activity distribution reflects the presence of COVID-19 response network partner organizations in a given geography, as
well as factors related to the pandemic response and local conditions. Supplementary Figures S2 and S3 present
the temporal distribution of total calls, callers, contributions and SOS messages over the 100-day analysis
period.
Uptake of SGC
Figure 2 illustrates the relative proportions of themes
accessed by listeners in 793 350 SGC calls representing
1 417 276 total minutes heard over the 100-day analysis
period. Basic health promotion (COVID-19 prevention,
COVID-19 basic information and FAQs, COVID-19
positive story, COVID-19 myths and misconceptions)
accounted for 67.91% (961 737 min) of SGC.
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From 9 June to 26 June 2020, a team of 15 trained field
staff performed data screening, extraction, entry and
verification. At the screening stage, a single team member listened to each audio file to determine whether it
was relevant or irrelevant to this study. Relevant items
were those that captured concerns of specific individuals
or groups of individuals in relation to the COVID-19
pandemic and public health control measures. Common
examples of irrelevant items included general news,
announcements or information not about any specific
groups or individuals. Relevant contributions were
retained for data extraction. During the data extraction
phase, relevant contributions were categorized according to a pre-defined coding scheme (Supplementary
Table S1). Each field was coded as a binary variable labelled ‘1’ if the code applied and ‘0’ if it did not apply.
Data entry was conducted using EPI Info version
7.2.0.1, while data management and analysis pre-processing were performed in Stata Version 15.
Steps were taken to ensure quality at each stage. To
minimize subjectivity in relation to data screening, two
independent raters scored 107 audio entries; the associated kappa value was 0.85 (almost perfect) (Landis and
Koch, 1977). To facilitate data extraction, a detailed
data coding form was developed based on a subset of
audio files by one author (D.C.) and categories were validated by two other authors (M.J. and A.S.) to ensure
that they were easily understandable, comprehensive
and mutually exclusive. The coding template was also
tested and refined by field staff prior to data extraction.
A minimum of 5% of all audio messages were randomly
selected for verification. Data mismatches were resolved
through repeating the process of audio consultation and
extraction with guidance from a supervisor.
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M. Johri et al.
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Analysis of UGC
The COVID-19 IVR platform recorded a total of 19 832
UGC items between 13 March and 20 June 2020. Of
these, 1161 were miscategorized SGC; these audio files
were removed from the data set. Of the 18 666 true user
contributions, 836 additional items were excluded for
the following reasons: 18 were duplicates, 749 were
not in Hindi or Urdu and 69 had a technical or audio
quality problem, leaving a total of 17 830 contributions
for data screening, extraction, entry and verification.
After exclusion of 11 194 non-relevant items, 6636
UGC contributions were retained for analysis. Figure 3
describes the construction of the UGC sample.
The issues raised by callers to the COVID-19 IVR
platform focused overwhelmingly on basic necessities of
survival (Figure 4). Analysis of the 6636 UGC contributions reporting 9015 issues found that 48% (4364)
recounted shortages of food or problems in accessing
food entitlements, 17% (1547) had insufficient funds,
were out of cash or faced problems in accessing cash
transfer related relief measures initiated by the government, 10% (963) required transport and 8% (755)
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Fig. 1: Spatial distribution of contributions to the COVID-19 response network, 13 March–20 June 2020.
The first 100 days
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related concerns about employment or livelihoods. These
problems were particularly acute during the first two
lockdown phases (Supplementary Figures S4 and S5).
We also mapped issues raised by callers to deficits in
attaining the SDGs (Figure 5). Analysis of 6636 UGC
contributions representing 18 764 issues related to the
SDGs revealed the following top 5 shortfalls: SDG2: zero
hunger (48%); SDG1: no poverty (acute financial distress
and concerns over livelihoods; 15%); SDG11: sustainable
cities and communities (basic living conditions, such as
transport, electricity, housing and cooking fuel; 13%);
SDG16: peace, justice and strong institutions (problems
with corruption and difficulties in accessing government
relief measures; 7%); and SDG3: good health and wellbeing (health issues such as COVID-19 rules or quarantine conditions; 7%). Patterns of SDG deficits differed by
gender (Supplementary Figures S6 and S7); for example,
female callers expressed more frequent concerns over
food shortages.
DISCUSSION
In India, stringent public health measures, including a
complete nationwide lockdown, were taken early on in
the hopes of slowing the speed of SARS-CoV-2 spread,
giving the health system time to adjust, and mitigating
harms to the population. On 26 March 2020, at the start
of the lockdown, the Government of India additionally
announced a range of measures under the Pradhan
Mantri Garib Kalyan Yojana (PMGKY, the Prime
Minister’s welfare initiative for the poor) to alleviate
impending financial hardships that would arise due to
the lockdown. Notwithstanding, the lockdown is widely
considered to have sparked India’s biggest humanitarian
crisis since the country gained independence in 1947.
How did this happen, and what can we learn from it?
The data presented in this article were generated
through uptake of an emergency response service and
did not follow a pre-established sampling design. They
constitute a very large convenience sample offering a
unique window into this humanitarian crisis from the
standpoint of the disenfranchised.
Individuals availing the services of the Gram Vaani
COVID-19 response network represent the poorer segments of society, choosing a communications medium
that is free of cost and does not require access to the internet, a smartphone or literacy. One of the network’s
key functions is to offer basic health promotion for
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Fig. 2: Thematic analysis of studio-generated content for the COVID-19 response network, 13 March–20 June 2020. Percentages
represent the number of minutes heard by category (N ¼ 1 417 276 total minutes).
1722
Fig. 4: Issues raised by callers to the COVID-19 IVR platform, 13 March–20 June 2020.
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Fig. 3: User-generated contributions included in the content analysis.
M. Johri et al.
The first 100 days
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individuals excluded from other information sources.
That more than 1 million calls were logged in just
100 days is testimony to the importance of this service,
which was a spontaneous and initially self-funded effort
of key Indian civil society organizations. While government health promotion focused on communications
channels oriented to the middle and elite classes such as
television, internet and newspapers, health promotion
for the most vulnerable was largely an afterthought.
Audio recordings made by network users spoke of
profound distress over struggles to secure the basic necessities of survival. Analysis of these recordings shows
that, for a large segment of the Gram Vaani COVID-19
response network callers, stringent public health measures to counter COVID-19 compromised the right to
health by threatening its essential determinants and
entitlements.
In India, due to a scarcity of jobs in rural areas and
growing agrarian distress, an estimated 100 million people are regularly away from their homes, working as
labourers in the construction and manufacturing industries in urban industrialized centres of the country. With
the sudden announcement of a lockdown, these migrant
workers found themselves overnight with no source of
income and no means to travel back to their homes
(Srivastava, 2020a). They soon ran out of food and
cash, and, as revealed by the intensity of SOS cries for
help on the Gram Vaani Interactive Voice IVR platforms, the food kits and community kitchens run by the
government soon proved inadequate. Many went hungry or undertook perilous journeys on foot or bicycles,
to reach their homes hundreds of kilometres away
(Ruthven, 2020). Many of these harms, including violations of human rights enshrined in the Indian constitution, could have been substantially mitigated through a
better consideration of the needs of the marginalized.
We illustrate gaps in three areas:
1. India’s Public Distribution System (PDS) scheme
provides subsidized food and non-food items to poor
households. While the government announced doubling of the subsidized food grains distributed via
PDS to support the poor whose meagre incomes had
been impacted due to the lockdown, many people in
rural and urban areas remained excluded. The PDS
in India is not yet portable across states, and migrant
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Fig. 5: Issues raised by callers categorized according to the UN 2030 Sustainable Development Goals. Elec—electricity; Farm—
farming, agriculture or livestock; Gas—Ujjwala yojana—gas for cooking; Gov—local governance (Panchayat); Hous—housing;
Profit—black marketing and profiteering/price rises; Relief—relief measures/financial services not working; Viol—violence, domestic or communal.
M. Johri et al.
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In ‘Listening as governance’, Indian Nobel prize winning economist and philosopher Amartya Sen describes
the need to address the COVID-19 pandemic by
strengthening participatory democracy and listening to
the poor (Sen, 2020). The experiences of callers to the
Gram Vaani COVID-19 response network reveal that it
is in fact pre-existing development deficits, such as failures in establishing an effective social safety net, that are
driving vulnerability during the COVID-19 crisis.
To build an inclusive recovery, the needs of the marginalized must be placed at the heart of policy design.
First, public policy must avoid exacerbating structural
drivers of exclusion, inequalities and discrimination. If a
sudden and strictly enforced lockdown was required, logistics to ensure provision of essentials such as transport,
food and cash, should have been mobilized to help vulnerable groups such as migrant workers and day labourers deal more easily with the situation. Second, as we
rebuild institutions, we must reinforce social protection
measures and be vigilant about the dangers of wrongful
exclusion. During the COVID-19 lockdown, a universalization of benefits such as subsidized food should
have been seriously considered as a useful measure to reduce the suffering of the poor, while relying on self-selection by people to keep inclusion errors low (Sen et al.,
2020). In planning for the post-pandemic recovery, adequate attention should be paid to reasons for exclusion
from social protection benefits, including technology-related failures, and to have clear protocols to handle
these cases (Seth, 2020). Moving forward, there is a
need for documentation of workers especially in the unorganized sector, as a gateway to ensure access to portable welfare benefits, unemployment benefits, skillsbased job matching and employment-based social security such as workplace health insurance (Tiwari, 2020).
The COVID-19 pandemic is both a crisis and an opportunity to reimagine more just institutions and policies. The voices of the marginalized must become central
to this dialogue.
SUPPLEMENTARY MATERIAL
Supplementary material is available
Promotion International online.
at
Health
AUTHORS’ CONTRIBUTIONS
Mira Johri: Conceptualization, Methodology, Writing—
Original Draft, Funding acquisition; Sumeet Agarwal:
Methodology, Writing—Review & Editing; Aman
Khullar: Visualization, Formal analysis; Writing—
Review & Editing; Dinesh Chandra: Supervision, Data
curation, Investigation, Writing—Review & Editing;
Vijay Sai Pratap: Project administration, Funding acquisition, Writing—Review & Editing; Aaditeshwar Seth:
Conceptualization, Methodology, Writing—Original
Draft, Funding acquisition; Gram Vaani Team:
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workers are thus unable to avail these benefits
(Srivastava, 2020b). Among non-migrants, an estimated 100 million people are also unable to avail
these benefits because they are not enrolled under
the PDS, either due to long pending applications, or
failed applications due to missing documents, or because they were excluded from the population survey
which
last
happened
in
2011
(Special
Correspondent, 2020).
2. The government also announced several cash transfer benefits to aid the poor during the lockdown, but
many could not avail these benefits due to implementation failures. We highlight difficulties related to the
technological approach adopted to operationalize
these transfers. Over the last few years, the use of
digital technology and biometric-based authentication has steadily increased as a means for people to
access social welfare schemes in India, both for inkind benefits like PDS, as well as cash transfers directly to people’s bank accounts. Network connectivity issues at bank branches and Point of Service
machines for authentication and recording of transactions, transaction failures due to server capacity
bottlenecks, inactive bank accounts because of discrepancies in identity documents provided by the
people, and a lack of physical banking infrastructure
in remote areas for people to be able to withdraw
cash, caused many to be needlessly excluded from
these programmes and led to significant
distress(Gupta et al., 2020; Raghavan, 2020).
3. The Indian health system, including community
health workers who operate in remote areas with underserved populations, was diverted to focus exclusively on COVID-19-related issues such as contact
tracing and door-to-door surveys. This came at the
cost of routine healthcare delivery, including access
for the emergency treatment of physical injuries, suspension of routine immunization sessions, suspension of nutrition programmes for pre-school and
school-going children and other health programmes
related to chronic conditions such as tuberculosis
and diabetes (Population Council Institute, 2020).
The disruption of primary health care and nutrition
services is expected to have a significant impact on
the future health of children and mothers (Roberton
et al., 2020).
The first 100 days
Supervision, Investigation, Resources, Software. All
authors gave final approval of the version to be published and agree to be accountable for all aspects of the
work in ensuring that questions related to the accuracy
or integrity of any part of the work are appropriately investigated and resolved.
ACKNOWLEDGEMENTS
FUNDING
We gratefully acknowledge the support of the Omidyar
Network India (ONI, as part of the COVID19 Rapid Response
Funding Initiative) to fund the COVID-19 response network
operations, Laudes Foundation, the Bill and Melinda Gates
Foundation for top-up funds on project #INV-002938 to extend
the scope to COVID-19 relief and awareness efforts and the ICIMPACTS Innovative Technologies Demonstration Projects initiative for research funding. The study sponsors played no role
in study design, in the collection, analysis and interpretation of
data, in the writing of the report or the decision to submit the
paper for publication.
ETHICS APPROVALS
Research ethics approval for this study was granted by the
Institutional Committee for Ethics and Review of Research,
Onion Dev Technologies Pvt. Ltd. (No. TV-OS/01-2020).
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