Assam Health System Strengthening Project (AHSSP)

The Assam Health System Strengthening Project, developed and executed with the support of the Japan International Cooperation Agency (JICA), represents a pivotal effort in enhancing the health sector of Assam. This initiative focuses on reaching the mandate of Universal Health Coverage(UHC) by improving access to public health care services and elevating the quality of medical care for communities within the state, by improving and enhancing the areas of hospital management and pataient care in selected Primary, Secondary and Tertiary medical care institutions. The AHSSP covers 8 pre-selected Medical colleges, 6 District Hospital and 40 CHCs/PHCs in the state.

VHAA has been involved in the capacity building of health professionals including doctors, nurses, lab technicians, hospital receptionists and BMWM nodal officers etc. besides developing a comprehensive training module on relevant and important issues of Patient Care including Infection Prevention and Control, Palliative Care, Comfortable Interaction, Informed Consent, Bio Medical Waste Management, Fire Safety and Disaster Preparedness etc. as ready reference for the hospital level health cadres.

Community Health and Development Initiative(CHDI)

The prime mandate of the Community Health & Development Initiative (CHDI), a CSR intervention of SC Johnson Products Private Limited (SCJPPL) in collaboration with Voluntary Health Association of Assam (VHAA) is to empower communities to enjoy good health and wellbeing .

Major Objectives of this initiative :-

• to ensure enhanced access to basic health services, free medicines to community specially women, children and elderly members living in and around Jyotinagar & Panikhaity
• to facilitate early identification and timely referral of cases requiring advanced level of diagnostic and health care services
• to strengthen a network of stakeholders such as project beneficiaries, Govt. Health workers, Health & Wellness Centres, Dist. Vectorborne Disease Control unit, Panchayati Raj Institutions( PRIs), Self Help Groups(SHGs) to address local health and developmental issues and concerns
• to enhance and sustain the level of awareness and sensitisation of community on Health, & hygiene, Nutrition, Communicable and Non- communicable diseases
• to conduct a range of activities such as basic health care services through OPD /Mobile clinics , Mosquito Net Treatment , Awareness & Screening of Non Communicable Diseases , Home Visits and Inter Personal Communication(IPC) , community mobilisation and awareness generation on Malaria and other vector borne diseases like Japanese Encephalitis and Dengue, RCH issues were planned for intervention.

Arogya - A Community Based Interventions on Non-communicable Diseases’ Prevention & Control in Assam

The Arogya focusses on both screening of high risk cases as well as follow up of earlier high risk cases to ensure that the patients were following the treatment regime as advised by the doctors at the Health Centres.

Community Awareness on NCDs and its associated risk factors :
Regular Awareness programmes were conducted at the community level and in educational institutions like schools and junior colleges by the Block Coordinators after consulting the community prior to conducting the same. It is significant to note that general awareness and sensitization of the communities is very essential not only to increase their awareness levels about healthy lifestyles and the risk of NCDs but also to make them aware of the existing facilities and services being provided by the existing government health services and schemes in the state/district especially the new schemes like Health & Wellness Centers & Ayushman Bharat.

It has always been our endeavour to ensure that the local communities avail the health services and facilities that are being provided by the government and to increase the footfall at the government health centres.

Symptomatic Opportunistic Screening:
Based upon the community Based Assessment Checklist (CBAC) of the Government’s National Programme for Cardiovascular Diseases, Diabetes, Stroke (NPCDCS), Arogya team has conducted screening of the high-risk cases who have attended our community awareness sessions for the risk factors of NCDs. Those cases whose (CBAC) score read 4 or more were screened at the screening camps. 56001 people were screened through CBAC.

Screening camps were conducted in difficult to reach and inaccessible pockets of the district, like in hilly terrain in and around Guwahati city, in rural blocks and slum pockets etc. and catering to the communities who may be working throughout the day. Hence camps were also conducted over the weekends, when the men folk in the communities find it easier to attend. Proper counselling of the positive cases as well as high risk identified was provided by the field team to encourage them to take preventive measures and make lifestyle changes to combat the chronic problem of diabetes/hypertension.

Follow Up and Referral:
Proper referral of the positive cases to the closest government health facilities has been an integral component of the Arogya project. All positive cases of the screening camps were referred to the local government health facilities. The follow up of the cases were closely done by the volunteers or Block Coordinators who follow up through visits, or through phone calls or through the local Anganwadi workers (AWWs), Accredited Social Health Activist (ASHAs) etc.

• to ensure enhanced access to basic health services, free medicines to community specially women, children and elderly members living in and around Jyotinagar & Panikhaity
• The main objective of referral and close follow up is to ensure that the individuals who has been identified as a high-risk cases, take prompt action by seeking the advice and health services at the Government Health Centre. This helps to:
• Ensure that the community is availing all the health services being provided by the Government Health Centres.
• Increase the patient footfall at the Government Health Centres and Wellness Centres.
• Support the government by identifying high risk cases and referring such cases besides creating an awareness amongst the people about the risks of NCDs and the importance of early diagnosis and treatment.
• Ensure that the communities are adequately sensitized about the risks of NCDs and the importance of leading healthy lifestyles, thus leading to a reduction in NCD prevalence in the district/state.

Stimulating, Appreciating, Linking, Transferring (SALT) Project

VHA of Assam continued to empower communities to consolidate their local ownership for health and related matter through the SALT approach in 20 villages of Kamrup (M) and Udalguri district.

The main objective of the project was to leverage the capacity of the community to integrate the process in a comprehensive and sustained manner as well as to document stories of success.

Other than the new Out Come Harvest tool for assessing the outcome of the project, the strategies and activities of the previous year continued. One Facilitator per district led the field activities taken by communities by listening and guiding as and when required for realising their dream .

The culmination event of the SALT project has always been an annual state level Knowledge Fair(KF) which is held with the theme “Communities take action on SDGs using Community Life Competence Process (CLCP)”.

Along with the community members from Udalguri, Kamrup and Bongaigaon districts, Accredited Social Health Activists (ASHAs), SALT champions,SALT facilitators and the representatives from the organisations such as MAMTA Health Institute for Mother and Child, Catholic Health Association of India(CHAI) were also present at the Knowledge Fair.

Renowned story teller of international repute, Ms. Laura Simms travelled all the way from New York, to participate in the Knowledge Fair, and listen to the stories of the communities from Bongaigaon, Kamrup and Udalguri. The main focus in the Knowledge Fair centered around-

• Problems which was solved through the SALT approach
• What motivated community to do the work
• Why didn’t they do it before
• What changes did it bring

The Knowledge Fair was a unique platform where not only the communities from the project villages in Bongaigaon, Kamrup and Udalguri came together to share their experiences in SALT and to share their stories, but it brought together other stakeholders like frontline health workers, PRI members, Ward members, government Missions like the NHM etc.

Community Mobilization for Improved Access to Sexual and Reproductive Health and Right (SRHR) including Safe Abortion Services

With the objective of making adolescent girls and young women aware of their Sexual and Reproductive Health and Rights, VHAA in collaboration with VHAI had initiated the project “Community Mobilization for Improved Access to Sexual and Reproductive Health and Rights (SRHR) including Safe Abortion Services” in November 2018 in some of the unreached and remote areas in specific districts of Assam namely Dhubri, Goalpara and Nagaon.

Targeting the youth, especially adolescent girls and young women in the age group of 15-24 years, the project is being implemented in the catchment areas of 12 Public Health Facilities in three districts of Assam.

This projects aims at strengthening Knowledge, Attitude and Practices(KAP) among young women on SRH services including safe abortion services.

The project also focuses on strengthening knowledge and practices of local health providers (doctors) and health intermediaries from selected public health sites to improve access to SRH services for young women, particularly in keeping with the Ministry of Health and Family Welfare, Govt. of India’s flagship programme for adolescent and young girls – the Rashtriya Kishor Swasthya Karyakram(RKSK)

Through this project, 71,131 young women were reached. An additional 14,477 young girls and women in the age group 15-19 years, 8,767 in the age group 20-24 years and 23,121 in the age group of 25 years and above were reached as well.

This goes a long way to prove that adolescent girls and young women were able to come out in the open with their doubts and queries in regard to SRHR issues, shunning taboos and social mores to seek professional help at the respective health facilities. The credit for this feat goes to the dedicated and sincere band of Youth Leaders.

Empowering Community-based Institutions to Increase Vaccine Confidence and Routine Immunization Demand, and Prevention of COVID-19

Even after intensive efforts, India is lagging in achieving the ambitious target of 90% Full Immunisation Coverage in the country. In India, rich experience gained through polio, MR campaigns indicate that community engagement has significant potential in addressing lack of awareness and misconceptions regarding vaccination at the community level. VHA of Assam and 6 other District NGOs in Assam, (covering the 7 Aspirational districts of Baksa, Barpeta, Darrang, Dhubri, Goalpara, Hailakandi and Udalguri have been working on community engagement for increasing the uptake of routine immunization services and for the last one year has also worked on promoting COVID-19 appropriate behaviours with support and guidance from VHAI and Unicef, India.

The Immunisation coverage in the 7 intervention districts at the start of the project(Sept 2019) was not up to the mark. The immunisation coverage in Baksa was less than 60%; Barpeta-34%, Dhubri- 20%, Darrang- 40%, Goalpara 43%, Hailakandi- 39% and Udalguri less than 53%. Considering the scenario, with the objective to achieve 90% coverage nation-wide, with the support of UNICEF a community driven program to strengthen the hands of the State Health Department to achieve 90% immunization in these 7 districts, was designed and strategised.

Through the collective efforts have succeeded in creating social capital by empowering community based organisations and Influencers for improving the community awareness on immunisation and COVID-19. The focus has been on identifying and mentoring proactive CBOs, CSOs, Influencers, SHG Groups, VHSNCs, Youth Clubs, PRIs etc to build on their role in promoting routine immunisation, hand washing with soap and COVID-19 Appropriate Behaviour(CAB).

In addition, the influencers have also been engaged for social mobilization of LODOR (Left Out, Drop Out, Resistant)families for Routine Immunisation(RI). These community groups and Influencers worked to make people at the community level aware of the importance of immunisation and addressing vaccine hesitancy and promoting the CAB and practices. These groups are also supporting the district and block level immunisation health teams in providing immunisation services in the communities and reaching to a larger proportion of children. As a result of the community engagement approach, the project teams have identified significant number of LODOR children in the intervention districts, and with the efforts of local CSOs, CBOs and influencers, more than 80% of them have been brought under the umbrella of immunisation.

Realising the Right to Adequate Food and Nutrition

The project “Realising the Right to Adequate Food and Nutrition aims to ensure that in Civil Society Organisations and the civil society at large, both in the “global south’ as well as the overall global context, can contribute to reducing the inequality and injustice for fair economic and social development. Central in this partnership are the women as (productive) actors in their communities, as well as caretakers and consumers who have specific needs. The ‘Right to Adequate Food and Nutrition’ focuses on special equitable access to nutrition by pregnant and lactating mothers and children below 5 years. of age.

In Assam maternal and child under nutrition still accounts for a high burden of morbidity and mortality in the state. According to National Family Health Survey (NFHS)-4,(during the period when the project was initiated) 37% children <5 years were found to be stunted, or too short for their age, which indicates that they may have been undernourished. 17% children were wasted, or too thin for their height, which may result from inadequate recent food intake. 30% were underweight which can be accounted to both chronic and acute under nutrition. 36 % of Children < 5 years were found to be suffering from nutritional anaemia due to poor diet or poor intake of food. 45% Pregnant Women in the age group of 15-49 years were found to be suffering from nutritional anaemia.

Keeping this problematic backdrop project “Realising the Right to Adequate Food and Nutrition” in Assam was started with a set objectives :

• Enhancing capacities of NGOs and Womens Federations for addressing the issues of malnutrition, and contributing towards achieving the SDG 2( Zero Hunger), SDG 5 (Gender Equality) and SDG 10 (Reduce Inequality )
• Convening with and convincing policy makers, stakeholder departments, etc. for effective implementation of nutrition related schemes, policy level changes etc and a multi-sectoral approach to addressing the issues of malnutrition.
• Identify and build up a potential women leaders Collective at community level
• Inclusion of disability and gender issues in policies and guidelines of concerned departments/sectors that are involved in improving Nutritional status.
• Ensuring that political parties give food and nutrition security proper focus and recognition in their party mandate.
• Post March 2020 and in view of the large scale problems caused at all fronts due the current COVID-19 pandemic, the project team also facilitated in providing COVID-19 responses at the community levels.

COVID -19 Interventions under all Projects :

When the entire world was rocked by the COVID-19 pandemic, India like many other countries went into lockdown mode from March 2020 onwards. However even though offices closed down or operated with skeletal staff, as a health based organisation, VHAA project teams swung into action to sensitise project communities on COVID-19 related protocols, de-mystify the new frightening virus, create awareness about COVID-19 Appropriate Behaviour(CAB) and to help and support communities amidst an all pervading atmosphere of fear and uncertainty.

• Arogya Facebook Account AROGYA created a facebook account on the Arogya project it was created for aware community facebook account disseminates information on NCDs as well as COVID-19 https://www.facebook.com/arogya.assam.
• Radio Programme: An hour long programme with Radio Mirchi and some other radio channels on awareness generation on Covid-19 & NCDs was broadcasted.
• Patient Support Groups on WhatsApp : Each Block Coordinator created WhatsApp groups with volunteers & NCD patients in the respective geographical areas served by them. Block Coordinators shared correct and relevant informative videos and messages on Covid-19 & NCDs in the Patient Support Groups and Patients were encouraged to call back or message their queries regarding Hypertension, Diabetes in the context of Covid-19.
• DOCTORS TELEPHONIC CONSULTATION : The Arogya team started a new initiative during the Covid -19 pandemic for follow up and patient support. Tele-Consultation sessions through conference calls for at least twice a week between medical professionals(doctor) and the patients were organised . In these sessions NCD patients could consult with Doctors for queries on their health /NCD status, COVID-19 related issues, changes in medicine dosage etc. in the presence of the Block Coordinators. 2435 patient were benefitted trough these tele-counselling sessions.
• Besides the above mentioned COVID-19 prevention initiatives, the team members were also included in district level disaster management groups during the first wave of the pandemic, wherein the team members actively contributed in distribution of dry rations, PPE kits etc. in the communities.

In the wake of COVID-19, fulfilling even the basic requirement of a meal every day, became a challenge to many households in our project areas as the source of livelihood has come to a stand still in most areas. The economic condition of most families are not sound and consistent as majority of the households comprise of daily wage earners, which means - no work – no earnings. In such a situation pregnant women and under 5 children suffer most when they are deprived of two square meals a day . The Under 5 age is a crucial stage in child development. Any impairment which occurs due to food and nutrition deficiency during this stage has a life long impact. No sector working for community development can ignore such a situation, which calls for immediate response.

VHAA received appeals from the communities, through our CHVs of the CHDI project, to help them by providing grocery and ration support to needy families.

Since with limited resources, providing ration support to each and every household was a huge challenge , so it seemed more justified to reach out to families having pregnant women, lactating mothers and children in Anganwadi Centres (AWCs) under the Integrated Child Development Services(ICDS) in Panikhaity as distribution of regular Supplementary Nutrition Services(SNS) was interrupted due to the pandemic situation.

Against the above mentioned backdrop, VHAA, under the CHDI project with support from SCJohnson Company, distributed a one time ration support to 995 families having pregnant women and children under 5 under 19 AWC pockets in Panikhaity area.

Since hand hygiene, respiratory hygiene that includes use of face mask and social distancing are three personal safety measures that need to be followed stringently by each and every individual at community level VHAA, under the CHDI Project started activities to sensitise communities on the transmission mode/s of Corona Virus and how to maintain personal protection measures.

15 numbers of public miking activities to reach out to larger number of people were carried out to curb panic and misconceptions by sharing correct and appropriate information.

At the initial stages of the pandemic and subsequent lockdown, information related support services were not streamlined very well which in turn led to the generation of panic and denial. The communities at large were at a loss, not having the right or adequate information in regard to issues like whom to contact ,where to go should they develop any symptoms . Our teams arranged to display Help Line numbers for community information at convenient places .

The project field teams , with guidance from VHAA team reached out to community members through telephonic calls, WhatsApp messages etc. to sensitise them about the ‘dos and don'ts’ of safeguarding themselves and their families and communities from the infection of COVID 19.

Keeping in view of the poor economic condition of the communities in project area, team members are coordinating with the local Panchayats and Ward members so that no family got left out from receiving ration and other food items support provided by Government.

VHAA project teams continue working in close collaboration with the government field workers like the ASHAs, Anganwadi Workers etc. thereby strengthening the government hands in the fight against the COVID-19 pandemic etc. during the lockdown period and after.

At the initial stages, prices of masks were very high and hence beyond the means of common people. Sushanti Das, a CHV of CHDI prepared hand made masks and distributed the same to elderly people and children in Rajabari Village.

4 demonstration sessions on hand washing and appropriate use , washing and reuse of cotton face masks, safe quarantine practices were held .

Families having members travelling back to the state from outside were reached out to by CHVs who sensitised the families and the communities about the ‘Do’s and Don’ts’ of safe quarantine . Sensitised communities made barricades at the entry points of their respective villages so as to restrict unnecessary inflow of people - an evidence of community commitment to take all the necessary precautions to protect their communities.

Convening and Convincing Activities on COVID-19 and Nutrition Security at the District and Block level :
Federation Leaders with guidance from the PW2 team carried out supportive supervision of distribution of ration to the needy people. The COVID-19 Protocols laid down by the State Health Department were strictly followed during the activity.

Federation leaders at district and block levels prepared lists of needy families including persons with disabilities and families who were not included in the list of BPL beneficiaries. The list was then handed over to the concerned local authorities at block level.

Based on the lists many beneficiaries who were earlier left out were able get the necessary entitlements. The Federation members with guidance from thePW2 team reached out to around 30,000 community members during the lockdown period through telephonic calls, whatsapp messages, etc to sensitise them about the ‘Dos and Don'ts’ of safeguarding themselves, their families and communities from the COVID 19 virus.

Federation Members liasoned with the local Panchayats and provided ration and other essential items to the community during the lockdown period .

The Women Federations mobilised funds locally to distribute relief materials in their respective areas. They also distributed fresh vegetables from the community kitchen gardens as part of relief material packs to lactating mothers, pregnant women and children below 6 years during lockdown and post lockdown period. They were successful in mobilising resources and engaging their members in production of masks. These masks were then distributed to the poor and vulnerable sections in the communities. During the post lockdown period (June-July, 2020) the women federations with guidance from thePW2 team carried out regular awareness activities on COVID-19 Prevention and Control and Nutrition Security at Block and Panchayat level by collaborating with local Panchayat Bodies.

As frequent hand wash is regarded as one of the most important aspect of COVID-19 prevention and control, Federation members also organised hand washing demonstrations at the community level to sensitise the people on proper steps that need to be followed for hand wash. Through their COVID-19 response work, the Federation members also ensured inclusion of women, children and the differently abled in their interventions. The Women Federation Leaders provided support to frontline heath workers (ASHA/ANM) during the regular Village Health and Nutrition Day (VHND) sessions during the post lockdown period. In the VHNDs they apprised the beneficiaries on what precautions need to be followed during the unlock period for COVID-19 control and what locally available nutritious items one should consume to boost the immunity.

Partnership with NGOs and CBOs at the District Level to tackle COVID-19 induced nutrition security issues.

COVID-19 Support Service:
VHAA under the Pathway 2 project initiated a COVID-19 Support Helpline service in all the six project districts to sensitise the communities on COVID-19 Prevention and Control and also to answer queries and enquiries on government and other services available on COVID-19 response.

The support help line service started operating from June, 2020. It was a telephonic help line service where the volunteers received as well as made calls to sensitise the community on COVID-19 related and nutrition security related issues. The Women Federation teams collaborated with Gaon Panchayats to make this Helpline service popular. They met the Secretary and President of the concerned GPs where they are working and apprised them about the COVID-19 Helpline number initiative they have undertaken with support from VHAI.

They distributed leaflets and pasted posters related to the COVID-19 support number at the Panchayat offices and urged the Secretaries and Presidents to widely circulate the numbers among the community. Official letters in this regard were also handed over to the concerned panchayats.

The federation leaders also maintained daily records of the calls they made and received. One call operator was in place in each of the six districts under this service. One Coordinator at State level helped to facilitate smooth functioning of the service. All the district level call operators were trained by the PW2 team during the month of May, 2020.

Below is the district wise break up of calls received from 1st June to 30th Sept, 2020

Donation of PPE Kits to the Hon’ble Chief Minister of Assam’s COVID-19 Relief Fund with support from Lal Pathlabs Foundation and Voluntary Health Association of India (VHAI)

VHA of Assam with support from Lal PathLabs Foundation and Voluntary health Association of India (VHAI) implemented Arogya – an initiative to prevent and control the spread of NCDs in the district of Kamrup(M) for the period Nov 2018 –Dec 2020. The project was a successful one and the efforts were much appreciated by the Health Dept. Govt. of Assam and NHM, Assam.

Lal PathLabs Foundation and VHAA and VHAI were keen to offer their support to the Govt. of Assam in the form of material support(PPE Kits etc.) for frontline health workers who are even now managing COVID-19 patients.

To take this forward, the VHA of Assam team sent a written request to the Chief Minister’s office stating our desire to contribute towards the CM’s COVID-19 Relief Initiative.

We were allotted an appointment with the Hon’ble Chief Minister of Assam, Dr. Hemanta Biswa Sarma wherein we discussed with him the kind of support that Lal PathLabs Foundation and VHAI would like to offer to support the good work being done by the Govt. of Assam for COVID-19 Management and Control in the state.

It was decided to provide PPE kits which would include Hazmat Suits, Oximeters, N95 masks, 3 Ply masks, and Disposable gloves.

In an appointment with the Hon’ble Chief Minister of Assam, Mr. Raja Sen, Zonal Sales Manager for the NE, Lal PathLabs, along with Ruchira Neog, met with the Chief Minister and handed over a sample set of the items being donated by LalPath Labs Foundation, VHAI and VHAA jointly. The Chief Minister expressed his gratitude and thanked both Lal PathLabs Foundation and VHAI and VHAA for their generous support.

The Hon’ble Chief Minister requested the Mission Director, NHM Assam, Dr. Lakshmanan S. to instruct his office to take delivery of the items from VHA of Assam.

This gesture of Lal PathLabs Foundation, VHAA and VHAI was very well appreciated by both the Hon’ble Chief Minister of Assam and the Mission Director, NHM Assam as well as the department of Health and Family Welfare, Govt. of Assam.

The news was tweeted on NHM Assam’s Twitter Handle as well as on their Facebook page.

As a further gesture of appreciation and the behest of the Chief Minister of Assam, the Mission Director also issued a letter of appreciation jointly to Lal PathLabs Foundation and VHAA acknowledging the donation.

Empowering Community-based Institutions for Routine Immunisation Demand Generation and Supporting Risk Communication and Community Engagement for COVID-19

The partnership with VHAI and Unicef to work in RCCE by empowering communities continued this year too, like in the past year. However this year the responsibility and the role of VHAA was increased and besides the implementation role in two districts namely Baksa and Udalguri, and the additional district of Namsai in Arunachal Pradesh, the mentoring and monitoring role was extended to the other states where the similar project is being implemented namely in Meghalaya and Arunachal Pradesh and in our home state Assam.

This year too focus was on identification of Left Out Drop Out and Resistant (LODOR) children and ensuring that all community members in the project area completed their COVID-19 vaccination. The project villages in the districts in all the states ie. Assam, Arunachal Pradesh, Meghalaya were selected in close consultation with the respective state and district Health and Family Welfare departments.

The main objectives of the project were

• to strengthen the community engagement model for social and behaviour change on COVID-19.
• to increase the awareness levels on various aspects of Routine Immunisation and COVID-19 vaccination
• to mobilise communities for following COVID-19 Appropriate Behaviour(CAB)
• to reach and mobilise communities living in hard to reach areas of some of the most underperforming locations.

The geographical coverage of the project was as follows :

As part of the programme activities Community Consultations were held in all the project villages with different members of the communities being served so as to further sensitise them about the importance of Routine Immunisation, COVID-19 Immunisation and COVID-19 Appropriate Behaviour(CAB).

During the Community Consultations, participants were told to change their behaviour according to the COVID-19 protocols. They were also counselled not to follow rigidity and oppose vaccination. They were apprised about the vaccine and its harmless effect.dialogued with the communities. This was possible as they were trained in an appropriate manner with technical knowledge.

Win With Vaccines (WWV)

This was another initiative on COVID-19 vaccination that VHAA implemented with support from NATHEALTH and Centre for Knowledge and Development (CKD).

VHAA was approached by CKD and NATHEALTH to be the implementing partner for this project in Assam, based on our longstanding contribution to improving the Public Health amongst communities in Assam and other states of the North East region.

Supported by NATHEALTH and CKD, WWV is an initiative to build COVID-19 Vaccine confidence in 4 low-coverage districts of Assam, namely Baksa, Chirang, South Salmara, Udalguri. This Initiative was based on recent studies that indicate vaccine hesitancy perpetuated by mysths and misconceptions, by an active Behaviour Change Communication(BCC) campaign.

Through the WWV, the Left Out, Drop Out and Resistant(LODOR) groups such as indigenous communities, women, senior citizens, vulnerable communities and youth were identified as the target population.

Geographical Coverage :
The WWV initiative covered hard to reach areas in selected blocks/villages of the aforementioned districts. These districts experienced low vaccination coverage and were identified for target intervention by the State and district Health and Family Welfare department.

Project Objectives :
The WWV initiative covered hard to reach areas in selected blocks/villages of the aforementioned districts. These districts experienced low vaccination coverage and were identified for target intervention by the State and district Health and Family Welfare department.

• Address barriers
• Bust myths and misconceptions around COVID-19 vaccines
• Confidence Building amongst communities to accept and complete their vaccination through an active and strategised BCC campaign
• Catalyse community mobilisation and participation through Influencers, engaged government stakeholders and onboard local talent groups.
• Engage government and private stakeholders for increasing coverage of COVID-19 vaccination.

Seamless Coordination for Maximum Effect:
Departments of Health, Education and the Livelihood Mission were identified as key government stakeholders to ensure smooth and effective implementation. Support from public departments, and community Influencers such as CBO members, teachers, School Management Committees(SMCs) health workers like ASHAs, ANMs, AWWs etc. were actively involved in the WWV campaign.

A detailed and step by step Communication package was conceptualised, designed, and used for wide outreach and easy comprehension by the target population. For instance multiple channels of communication were chosen like Radio Jingles in local dialect, Wall Writing, Miking, Street Plays, Messaging on Social Media, simple and lucid Information,

Behaviour Change Communication (BCC) materials, Community Consultations to make the Campaign inclusive and to overcome literacy barriers. All BCC materials focussed on two target populations ie. 2+1 for the adult population and 1+1 for children between the ages of 12 and 17 years. The BCC strategy focussed on ‘Full Vaccination, Full Protection’ which later became the popular Tagline for the WWV campaign. Through the BCC campaign, the availability of free vaccination at the nearest government health centres was further reiterated.

What emerged as Best Practices in the WWV project was the following :

• Community Engagement for understanding the barriers and leveraging local resources
• Multi stakeholder engagement for designing and implementing the programme
• Development and Dissemination of the BCC campaign