EHS-COVID (417) M<eeting the health needs of vulnerable populations in India

21 June, 2021

Dear HIFA members,

This paper looks at the health needs of vulnerable populations in India, and notes that the services they can afford 'are cheap in quality and might make them even more sick' (it is not clear whether this refers to low-quality allopathic or ayurvedic care, or both). As with other paers we have seen, this one is sanguine about the role of mobile health, even for poor populations 'even the poor have a mobile phone or access to one'. Has anyone on HIFA seen actual evidence that mobile health improves access to health services and/or improves health outcomes in vulnerable populations?

CITATION: Thomas, J., de Wit, E.E., Radhakrishnan, R.K., Kulkarni, N. and Bunders-Aelen, J.G.F. (2021), "Mitigating the COVID-19 pandemic in India: an in-depth exploration of challenges and opportunities for three vulnerable population groups", Equality, Diversity and Inclusion.


Purpose: The COVID-19 pandemic is certain to have an unprecedented impact on the global population, but marginalized and vulnerable groups in low-income countries (LICs) are predicted to carry the largest burden. This study focuses on the implications of COVID-19-related measures on three population groups in India, including (1) migrant laborers (of which a majority come from Scheduled Castes (SCs) and Scheduled Tribes (STs), as well as Other Backward Classes (OBCs)), (2) children from low-income families and, (3) refugees and internally displaced persons (IDPs).

Design/methodology/approach: This study adopts a sequential mixed-method research design. A desk-based study of a selection of government reports was undertaken on the COVID-19-related mitigation measures. The desk study was followed by in-depth interviews with purposively recruited high-ranking experts in specific sectors of policy implementation and service delivery across the country.

Findings: The outcomes of this study shed light on (1) the most urgent needs that need to be addressed per population group, (2) the variety of state-level responses as well as best practices observed to deal with mitigation issues and (3) opportunities for quick relief as well as more long-term solutions.

Practical implications: The COVID-19 pandemic has not only reduced people's means of maintaining a livelihood but has simultaneously revealed some of India's long-standing problems with infrastructure and resource distribution in a range of sectors, including nutrition and health, education, etc. There is an urgent need to construct effective pathways to trace and respond to those people who are desolate, and to learn from – and support – good practices at the grassroot level.


"What is difficult, furthermore, is that migrants, because of the language barriers, and because their employers are sometimes actively hiding them, do not have access to information and services. We cannot reach them easily. They go to services that are somehow affordable to them, which are cheap in quality and might make them even more sick." (program manager of a child welfare organization in Rajasthan)

'Opportunities might be found in the experience of Mobile Health and other services provided through mobile applications and networks as most people, even the poor, have a mobile phone or access to one... Digital infrastructure, supported by physical care, might empower communities by providing them the right information, guidance and protection, and thus reduce the burden on the health system.'


Neil Pakenham-Walsh, HIFA Coordinator,