Thread by @prashanthns

1/ Shared few insights emerging from community-based #COVID care that some communities have begun in #Adivasi populations in #Chamarajanagar with support from #ZillaPanchayat in live video interaction with #Karnataka #GramPanchayats thanks to @gokRDPR

2/ #COVID19 care needs to be rational & #evidence-based but also respectful & dignified; these are not aspects we have done well with in our #HealthSystem & hence need special attention;

3/ Dignified & respectful care requires an awareness of diverse socio-economic & cultural contexts at individual, household, neighbourhood & societal levels; we haven't substantively engaged with (#caste #gender #disability #sexuality #privacy )-aware care at systemic level

4/ These can and have been done; see for eg. plenty of work on #culturalcompetence of #healthworkers who work in #Indigenous populations in some countries; but these require higher level systemic acknowledgement and problematisation of these...what we deny we wont solve

5/ One of the ways in which this can be addressed to some extent is by solutions that are decentralised, for eg. to #Panchayat levels; easier for people to ask for accountability from Panchayats than from higher & faraway authorities;

6/ they are also more likely to be aware of diverse socio-economic & cultural contexts than faraway authorities; but not always; they can also get captured by local level power structures; can also go wrong in other ways

7/ Without over-romaticising the local, always better to go wrong on small scale than to err at the large; lets build local capacity at ward, village and local levels for #COVIDThirdWave and stay away from far-away #expert-driven solutions & move to collective local solutions