Is ‘centralisation’ limiting vaccination drive?

India’s race to stay ahead of the renewed Covid-19 surge with an accelerated vaccination programme is being hampered by perceived centralisation roadblocks, going by complaints from states that want to ratchet up the numbers but can’t do so because of reasons ranging from single-window registration to lack of flexibility in expanding the network of centres and inoculating willing citizens beyond the stipulated age bracket even when vaccines are available.In Tamil Nadu, where several health centres run by the Greater Chennai Corporation are believed to be unofficially vaccinating people above 18, senior government doctors said a dynamic system that allows states to widen coverage — depending on vaccine availability and registration density — was the practical way to prevent wastage. “Once opened, a vial has to be used within four hours. Chennai has the capacity to vaccinate 60,000 people. On a good day, we vaccinate about 35,000, but sometimes the number drops to 15,000. Why not offer the vaccine to willing young or healthy individuals?” said a doctor.Officials of the Nagpur Municipal Corporation said they were still awaiting the government’s permission to begin vaccination in 32 private hospitals that are currently not empanelled. Vaccination numbers can increase by around 10,000 a day if these proposed centres join the network. “Eleven of these hospitals had done a commendable job in inoculating healthcare and other frontline workers – so it’s not as if they aren’t fit for the exercise,” an official said.81816164Some days ago, Nagpur district’s guardian minister Nitin Raut had directed the corporation and the zilla parishad to double the vaccination target to 40,000 a day by increasing the number of centres from the existing 160 to 300. Raut suggested that mobile vaccination centres be sent to residential areas to inoculate people in age-appropriate groups. The option of vaccination at home should be available for bed-ridden people, he said. But for all of this to be possible, the guidelines would need tweaking, something that states say they aren’t allowed to do yet.In Bengaluru and elsewhere in Karnataka, the topdown approach to vaccination is impeding execution on the ground, a senior civic official alleged. “The political bosses insist that we wait for directions from the Centre. The initial days of vaccination for senior citizens was chaotic as Co-Win was full of glitches. However, we allowed walk-ins without making any announcements and the situation stabilised. Even when it comes to implementing Covid-containment measures, we are told to wait as the state government has to get permission from the Centre.”Karnataka’s March 14 request to the Centre to allow vaccination teams to visit old-age homes and remote villages was shot down by the Union health ministry. “Since there is a BJP government in the state, the political honchos prefer a wait-and-watch approach,” the official said.Epidemiologist Dr Giridhara R Babu, who is a member of Karnataka’s technical advisory committee on Covid, suggests that offline and walk-in vaccinations should be encouraged instead of pre-registration and over-reliance Co-Win. “The Centre and the state governments should work on micro plans to increase the pace of vaccination,” he said.According to experts, over-centralisation of the drive has meant lack of initiative by state governments and local bodies to encourage the target population to register for vaccination. Earlier this week, at least 50 villages in Gujarat’s Rajkot wrote to the district administration, saying they wouldn’t allow health teams to enter their areas for vaccination. “We need to involve the RWAs and Anganwadi workers, and advertise the need for mass immunisation,” Dr Vinay Aggarwal, former national president of the Indian Medical Association, said.Andhra Pradesh’s Covid-19 nodal officer Dr Rambabu said the administration’s wait-and-watch approach had negatively impacted the vaccination drive. The health department last week launched a campaign in villages to improve inoculation coverage. Gujarat’s relatively better vaccine performance of about 2 lakh people daily is speculated to be the result of unofficially bending the rules.

from Economic Times https://ift.tt/3fDRpkS