India’s Rural Medical Revolution: The Attitudes of Villagers to Village-Level Blood Testing in Maharashtra

Can Self-Administered Rapid Antigen Tests (RATs) Help Rural India? An Evaluation of the CoviSelf Kit as a Response to the 2019–2022 COVID-19 Pandemic

“…The bulk of our research has dealt with poor, semi-literate people in marginalised and socio-economically disadvantaged households. Our most recent research in Wardha District (Maharashtra) involved 36 in-depth interviews with farming groups defined by various criteria: a high proportion of families living below the poverty line, households with very little irrigated land, poor farmers, landless villagers and tribal or Dalit families [43]. Our findings showed that poor rural households are preoccupied by three major concerns.…”

“…Following the logic of discourse analysis, we then widened the context for understanding the CoviSelf leaflet even further by using a third data source, namely our own 'expert opinion', as documented in peer-reviewed, published research about living conditions in Indian villages. Fieldwork in central India before the pandemic showed us that villagers were receptive to point-of-care blood testing at their doorsteps [43]. We assumed, therefore, that there might be positive responses to the idea of using the self-administered CoviSelf RAT kit because the demand for modern medical interventions is driven by the desire to prolong longevity.…”

“…In extending the context in which to understand the benefits and limitations of Co-viSelf, we have drawn on our own research published in peer-reviewed international journals and books. Vicziany has published on the poverty and marginalisation of Dalits (former 'untouchables') [60], the family planning program [61,62], food security [63][64][65], Koli villages in Mumbai [66] and rural health [29,43,47], including work on the potential of point-of-care blood testing in villages [29,43]. Hardikar has reported extensively on questions of rural poverty, co-authored work with Vicziany on poor farmers, agriculture and health [29,43] and has published two books on India's farming crisis [30,67].…”

“…Even in states that have seemingly adequate rural health infrastructure (such in Maharashtra), the human resource constraints are serious. The result is that villagers bypass government rural medical institutions and travel considerable distances to clinics and hospitals in or near towns [43]. While this is costly, rural residents have the satisfaction of getting a more timely and reliable diagnosis of their condition, a prescribed treatment regime and admission to hospital in urgent cases.…”

“…The appearance of the private health sector has resulted in villagers experiencing a medical revolution, with entrepreneurs working to make their hospitals more accessible and affordable to the poor by offering 'membership cards' and using their political links to help residents in need of attention. In return, these entrepreneurs and politicians are rewarded when their beneficiaries vote for them in elections [43].…”