How to ensure women are not left behind in India’s vaccination campaign

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  • India is making massive efforts to vaccinate its population against COVID-19.
  • But less than half of those vaccinated are women.
  • Women face many barriers to accessing and informing about vaccines.
  • How to Increase Women’s Vaccination Rates and Help Women’s Health.

The gender gap in India has always been skewed, with most health indicators, literacy levels and employment statistics favoring men. As India launches its largest vaccination campaign against COVID-19, that loophole is glaring – and needs to be closed.

It is estimated that more than 58 million doses have been administered to date on August 24, 2021, more than the total population of some countries in the world. However, women make up only 46% of the total vaccinated population in India.

As a public health professional, I’ve seen this discrepancy before. During my tenure with the Indian Government Technical Assistance for Immunization, I visited most of India’s states for reviews, surveys, and programmatic evaluations related to the Universal Immunization Program, hailed as the largest immunization program in the world, reaching 26 million children and 30 million pregnant women annually with life-saving vaccines. In 2015 I founded the non-governmental organization Samarpann to deal with socio-economic issues on the ground. Since the COVID-19 outbreak, we have been working to create awareness and access to the COVID-19 vaccine for women.

In this work I have spoken to numerous women – mothers, carers, and frontline workers – in urban and rural settings. I have found that women’s health is often neglected for several reasons, and that these challenges have been exacerbated by the pandemic.

What is preventing women in India from receiving a COVID-19 vaccine?

Too often women are not the decision makers in their health. Their fathers, husbands and sons dictate how they manage their health. According to the National Family Health Survey, more women would let their husbands make decisions about their health care than those who said they make decisions for themselves.

In addition, women who are not employed are often not considered to be at risk of developing the disease. In addition to this challenge, vaccination sessions are held during the day when many are busy with household chores or looking after their children. Day wage women make $ 2-3 a day and cannot afford to miss a day of work. Two square meals a day are more important to them than protecting against an illness that they have not yet infected.

Dr.  Ruma Bhargava is holding advocacy session in Hanotia village, Rajasthan, to overcome hesitation about vaccines.

Dr. Ruma Bhargava is holding advocacy session in Hanotia village, Rajasthan, to overcome hesitation about vaccines.

Image: Dr. Ruma Bhargava

These challenges are compounded by the fact that the vaccination centers or the mobile camps are often far away from their homes. Since many women are dependent on men for their mobility, this would mean that both of them would become unemployed. The lack of vaccines exacerbates hesitation as they are still not given a chance despite long trips and days off.

Fear of vaccination side effects is another obstacle. Many women fear that they will have side effects and miss additional work days. In addition, paracetamol is rarely given in rural areas, which means that if they had a fever after vaccination, they could not treat it.

Another difficulty is low digital literacy and poor access to smartphones, which makes it a challenge for women to book appointments at vaccination centers where online registration is mandatory.

Dr.  Ruma Bhargava heads an advocacy group for women of the Garariya Luhaar tribe in Rajasthan.

Dr. Ruma Bhargava heads an advocacy group for women of the Garariya Luhaar tribe in Rajasthan.

Image: Dr. Ruma Bhargava

What can we do to increase COVID-19 vaccination for women?

At Samarpann, we work with panchayats (local government agencies), local school teachers, and community leaders to combat popular fears and reluctance. Women have come up to me asking if vaccination is safe during menstruation and if they can take it during pregnancy or while trying to get pregnant. The vaccination is completely safe during pregnancy and has no connection with impaired fertility in a woman or a man.

Government and society are facing a mammoth task. To close the vaccination gap, the government must invest in behavior change communications – with face-to-face communications from doctors, frontline staff, and local community leaders. The government also needs to organize more camps near villages to make vaccination sites more accessible and to make registration outside of cities in urban areas more frequent.

There must also be strategies in place to create non-financial incentives to compensate for lost work for poor families who are vaccinated. Samarpann, for example, provides children whose parents are vaccinated a 10-day ration and a year of stationery.

Above all, women need to be empowered. This applies not only to the COVID-19 vaccination, but also to improving every aspect of their health, education and livelihood. Empowerment will come with financial independence, changing mindsets, equal opportunities, and overcoming the social barriers that hinder their progress. Society cannot afford to leave women behind.


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