The last-mile challenges in vaccination
Covid-19
This article talks about the supply chain challenges - more specifically, the last mile challenges we face today in vaccine delivery. Last-mile means the very last step of the supply chain. For example, in e-commerce, last-mile would mean delivering from the transportation hub to the end customer’s doorstep. In our context, I mean asking people to come to the vaccination centre and get vaccinated.
I recently got my second dose and these are my first-hand observations.
The process:
Go to the centre and take a coupon
Wait for your turn and give your Aadhar card number and your first vaccination reference number (not asked in some cases)
Get in line for the vaccination and get injected
Challenges
1. Not enough vaccination centres
We’re talking about administering vaccines to a billion people. Since Covid did not come with a warning, setting up vaccination centres was not going to be easy. Each vaccination centre needs to be accessible to people, should be a big enough place where people can stand in line while waiting, a computer and internet connection for data entry in the database and a couple of certified professionals for administering the vaccine.
In addition to this, each vaccination centre also requires multiple people to manage the crowd. The vaccination centre I visited had 6 people who were simply managing the entire place. All of this isn’t easy (and definitely not cheap) to find - remember, we’re giving free vaccinations. Hence, the government has to take the burn that goes in booking these places (or the opportunity cost if it’s a government-owned property).
2. Digitizing a non-digital population
While smartphones may seem like a given for some of us, that isn’t necessarily true. As of 2020, only 500 million people had smartphones in India and of those, only 77% had access to the internet.
Now, many international countries and even some states in India would require outsiders to provide a vaccination certificate while entering their territory. This makes the need for a digital certificate necessary. The primary key against which that happens is your cell phone number (and Aadhar card in some cases).
Now, if you do not have an internet connection or a smartphone, that is another challenge. The team at the last mile has to teach the people getting vaccinated about how to download the certificate. Also, some people don’t even have a cellphone or Aadhar card (Where will you send the OTP?). For them, the primary key itself is missing. There are ways around this, but again that’s an admin-heavy and time-consuming task. It isn’t straightforward when people don’t even know the full form of OTP.
These are just the issues on the last mile. There are challenges of bringing these vaccines from the delivery centre to the vaccination centre. Keeping inventory count, the cost of logistics and storage etc. We’re a developing country with a severe lack of resources. COVID hasn’t helped government revenues either. The point I’m trying to put across is that this isn’t a simple process and the government is doing a fabulous job. My vaccination certificate was available within 2 hours on my account on the CoWIN portal after I was vaccinated.
Did you know?
You can simply send a WhatsApp message “download certificate” to 9013151515 and get your vaccine certificate!
Lastly, I also want to point out that I live in a fairly developed city with access to a structured supply chain. 70% of India lives in rural areas. The challenges are tremendous and creating a supply chain across a country as big as ours is no small feat. Credit where credit is due - the government has done a fine job with the process. Giving vaccines for free is not something we should take for granted.
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