Evidence Action exists to bridge the gap between rigorous research and pilot interventions on one hand, and at-scale, real-world solutions on the other. Our work is focused on the global poor, who face not just the immediate threat of the coronavirus, but the pandemic’s compounding impact on existing health, education, and economic challenges.
We are working urgently to identify and implement approaches that reflect the time-critical nature of an emergency response, while maintaining our commitment to evidence-based, cost-effective impact at scale. Our approach is two-fold:
- Ensure continuity and/or rapid recovery of critical services we already support, and
- Augment our activities and/or pivot our approach to provide support where it’s needed most.
Recently, we shared the extraordinary efforts of our Dispensers for Safe Water team in Africa, who managed to compress three months’ worth of program deliveries into just two weeks, ensuring continued access to safe water for over 4 million people in the event of logistical shutdowns. The team continues to go above and beyond their usual scope of work, providing soap and disinfectant, and sharing key public health messages to help slow the spread of COVID-19 in vulnerable communities.
In India, Evidence Action supports national and state governments to deliver high-impact, cost-effective health interventions at scale. Through our Deworm the World Initiative, we support the Government of India to reach over 250 million children each year through National Deworming Day, and provide customized technical support in 11 states. In four of these states, we also provide technical assistance on the Iron and Folic Acid (IFA) Supplementation program for children aged six months to 19 years. These government-led programs demonstrably improve health and education outcomes for hundreds of millions of children across the country.
Both National Deworming Day and IFA Supplementation are school-based programs that leverage existing education infrastructure to achieve massive scale. Due to India’s lockdown measures, which include large-scale school closures, school-based programs are unlikely to resume in the near-term. We are therefore working to determine how best to support the rapid recovery of these programs once schools reopen, while simultaneously leveraging the capacity of our team in India to assist our government partners in managing COVID-related challenges. We are currently providing support outside our usual programming in six states: Madhya Pradesh, Uttarakhand, Tripura, Haryana, Jharkhand, and Rajasthan.
Resumption of IFA Supplementation
India’s Ministry of Health & Family Welfare recently issued guidelines to all states recommending the resumption and maintenance of non-COVID essential services, including IFA supplementation for children and adolescents through door-to-door visits by accredited social health activists (ASHAs) and anganwadi workers (AWWs). Leveraging our work on IFA Supplementation, Evidence Action has developed and rolled out a guidance note for IFA supplementation at the community level during COVID-19, and a technical assistance plan to guide our own work in the four states we support on IFA.
Communication and training for frontline healthcare workers
Thousands of frontline workers in India are engaged in essential service provision such as case monitoring, community awareness-building, and distribution of essential medicines. These workers are under immense pressure from the constantly evolving COVID-19 threat; clear, consistent, and efficient communication is critical. In addition, the scale at which India must respond to the pandemic renders in-person training unfeasible, and other ways to equip frontline workers to carry out their crucial work are needed.
Evidence Action is supporting the development of brief training and orientation ‘capsules’ for distribution via platforms such as SMS; in one state, over 75,000 workers have already received the first set of eight messages on key topics. Our team is also calling AWWs, ASHAs, and auxiliary nurse midwives (ANMs) to supplement other communications, assess the effectiveness of the training capsules, address knowledge gaps and misconceptions, and ensure workers are well-equipped to disseminate correct, and up-to-date information to their communities. To date, the team has made over 27,000 calls in Madhya Pradesh alone.
Remote data analysis support
In line with Evidence Action’s commitment to real-time, data-driven decision-making, we provide government partners with live dashboards showing data from our communications with frontline workers. These dashboards are used to support strategy and decision-making at the state, district and block levels. In Haryana, we are also undertaking a comparative analysis of hospital preparedness, looking at beds, ventilators, personal protective equipment (PPE), human resourcing, case loads, and contact tracing capability.
Communication with target populations
In addition to frontline healthcare workers, we are supporting the state governments of Uttarakhand, Rajasthan, and Jharkhand to communicate with key groups in the community. To date, around 8,000 calls have been made to people who are COVID-positive; people who have recovered from the virus; people who traveled prior to implementation of lockdown measures; people in quarantine; and specific at-risk groups (such as the elderly, people in regional hotspots, and people identified through contact-tracing apps). The calls serve both to provide information and advice, and to collect information on, for example, demographics, locations, and whether symptoms are being experienced.
Social media is a real-time, far-reaching, and low-cost platform. At the same time, its ability to propagate misinformation can have detrimental effects. Our team is supporting state governments to create clear and credible messaging, in both English and local languages, for sharing on departmental social media channels.