Logic behind India, a country of 1.3b with a high absolute COVID caseload and much better access to vaccines than most of the developing world, relying on apps/proactive registration to get the vaccine to its population eludes me. It’s reached ~6% of pop in ~3months. A thread. 1/
Insisting that people voluntarily and proactively sign up for and go to vaccination appointments is simply not using well-understood principles of how to conduct mass vaccination campaigns, many of which are based (formally or informally) on insights from behavioral science. 2/
Firstly, we know that small hassles or hurdles disproportionately deter take up of even beneficial services. This means that crashing websites, travel delays etc will be enough to deter even people who are not hesitant to take the vaccine from getting vaccinated. 3/
Instead, conducting vaccination in neighborhood open spaces, parks, community centers etc will ensure that hassles, travel time/cost etc are minimized. So would on-the-spot registration preceded by good old-fashioned information campaigns (think autos with loudspeakers). 4/
This has another beneficial effect. Vaccination becomes public, visible to neighbors, peers, etc. This - via what behavioral economists call “social proof” - will increase take up as potentially hesitant people see others “like them” get shots. 5/
Even in wealthier areas, allowing household help, local vendors, etc to be vaccinated will both ensure that the people who most regularly come into contact with residents get vaccinated, while also decreasing inequities. 6/
Many also have faulty mental models of how vaccines work, and who needs to get one: they think of “injections” as “curative” & thus think they don’t need a vaccine if “they’re fine”. More information aside, seeing other healthy locals get the vaccine may help reset these. 7/
This is a bit like how more initially hesitant healthcare workers are now willing to take the vaccine, after seeing older people etc get it with no problems. Instead, of course, the government is telling such people they’ve missed the boat - exactly backwards. 8/
Holding neighborhood vaccination days also removes need to decide *when* & *where* to get vaccinated. Otherwise, “choice overload” can lead to procrastination & reduce take-up. If there are multiple days, ask people to plan (“implementation intentions”) and commit in advance. 9/
Allowing/encouraging workplaces, restaurants, offices, shopping complexes to host vaccination days will have similar benefits. People see others (like them, healthy, etc) get it, protects those out & about, gets vaccines where ppl already are, reduces hassles/procrastination. 10/
In general, making vaccination easy, convenient, proximate, & visible; reducing need to take proactive steps/paperwork to register/prove eligibility; making it available to as wide a range of people as possible, will all help raise vaccination rates. Which is what’s needed. 11/
And, rely much more on old fashioned, unsexy information and outreach campaigns at the local level, using public health workers, school teachers, etc. India has vaccinated enormous numbers quickly for polio, earlier smallpox, etc. This is not new, nor do the solutions need to be.

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More from @sd268

15 Mar
I was surprised that @sarkar_swati, who claims expertise on Bengali society/culture, was unaware of something as basic as castes in Bengal having been classified as “(A)Jol-chol”. Since she insisted I was somehow concocting this, here are some references for her edification. 1/
Dasgupta, A (2000), “In the Citadel of Bhadralok Politicians: The Scheduled Castes in West Bengal”. Journal of the Indian School of Political Economy. ispepune.org.in/PDF%20ISSUE/20…
Roy, U (2010), “Aestheticizing labor: an affective discourse of cooking in colonial Bengal”, South Asian History and Culture. “...the most significant distinction in caste status .... was in terms of jalchal and ajalchal...”.doi.org/10.1080/194724…
Read 8 tweets
14 Mar
Hinduism has always policed temple entry & access to drinking water sources (think caste-segregated wells), punishing those who flout these “rules”. Poor Asif was “punished” for his “transgression”, as countless Dalits have before him. Be appalled, but spare me the surprise. 1/
I’ve been to many villages in Rajasthan and UP where people from disadvantaged castes would be risking death if they dared to try and drink water from a well earmarked for so-called “upper” castes. And the situation is no different elsewhere in the country. The entry of Dalits 2/
..into temples was fought tooth and nail by Brahmins and other “upper” castes. In Bengali, the term for castes who are of “similar” status is “jol-chol”, ie quite literally “those whom you can share water with”. Not sharing space, water and food: this is CENTRAL to caste.
Read 6 tweets
13 Jul 19
Bangladesh’s excellent human development/social indicators are deservedly lauded as far better than India’s, but I was curious how they compared to West Bengal, arguably a very good comparator. So here are some data. 1/
Total Fertility Rate: West Bengal - 1.6 (2016 estimate); Bangladesh - 2.17 (2017 estimate). So both Bengals have dramatically reduced their birth rates, but West Bengal has actually done even better and is now well below replacement levels of fertility. 2/
Literacy: West Bengal (77.1%) again higher than Bangladesh (72.8%). WB rate is from 2011 and Bangladesh’s is the UNESCO estimate for 2017, so the gap may have changed assuming both continued to become more literate. 3/
Read 12 tweets

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