Introduction
“India, like other countries across the world, is grappling with its worst public health crisis. In times like these, collaborative models are more effective in both containment of the disease and support for those whose livelihood and even survival is at risk” —Neeraj Akhoury, MD and CEO, Ambuja Cements Ltd.
“We are facing the worst pandemic in recent times. Our lives have changed – uncertainty and concern overwhelm us. But we have already adopted some new ways of functioning and should be prepared to embrace more as we start to operate in this environment” —Narotam Sekhsaria, Chairman, Ambuja Cement Foundation
We thank Ambuja Cements Foundation for their significant contributions to this case study write-up (including all uncited details).
The corporate social responsibility (CSR) arm of Ambuja Cements has been at the forefront of raising awareness in rural India about COVID-19. Ambuja Cement Foundation (ACF) formed teams of health workers, including Sakhis (community health workers) and volunteers (approximately 10001), to assist “intervention villages,” villages in the states where Ambuja Cement is located (Gujarat, Himachal Pradesh, Maharashtra, Rajasthan, Chhattisgarh, Punjab, West Bengal, Uttar Pradesh, Uttarakhand, Andhra Pradesh, and Madhya Pradesh). They educated villagers on handwashing procedures, social distancing norms, and the benefits of quarantine, among other things. Additionally, ACF health workers distributed information, education, and communication (IEC) items to further promote awareness about COVID-19.2
Government officials were taking every action they could to contain the COVID-19 outbreak, including expanding health facilities, during the initial phase of COVID-19 response. After being educated about the virus by ACF health teams (and following orders from the local authorities3), communities also played their part – by closing their village entrance gates and preventing strangers from entering and exiting, for example. The active groundwork of ACF teams in core villages where Ambuja Cement is located helped people understand the importance of taking stringent preventative measures.4
As of November 2021, ACF health teams had reached out to 22 districts affecting nearly 2,000 villages, 652,000 households, and 3.4 million people altogether.
In about 25 years, ACF has spread to 2,613 villages in 45 districts across India.5 It has helped the villagers in various fields such as agricultural productivity; training people to become a skilled workforce and to manage water to the remotest of the places; providing health care and education; and generating employment opportunities for women.5
How can you replicate or adapt this promising practice?Prepare proactivelyThe ACF health teams mapped basic health care services throughout the ACF districts and villages where ACF has a presence. They coordinated with local public health systems and enlisted testing, quarantine, and treatment centers. They created a directory of toll‐free numbers, primary COVID-19 contacts, and essential services, including a public distribution system. At the same time, the team appointed COVID-19 medical specialists and investigated oxygen and ventilator availability along with ambulance services for the community.6 Collaborate across sectorsIn the state of Maharashtra, ACF aligned with the local health department to reach out to ACF intervention villages. In the state of Gujarat, they collaborated with special COVID-19 Dhanvantari Raths (vans that provide people with mobile check-ups and medicines) for screening and treating villagers and promoting behavior change communication awareness. They also supported health surveillance in villages by associating with COVID-19 care centers in Dolasa, a village in the Junagadh district of Gujarat.6,7 Build village institutions for sustainable impactACF believes in the power of partnerships and engagement of multiple stakeholders in sustained ways for community betterment. Apart from liaising with government officials, corporations, and non-governmental organizations, they have developed village-level institutions like self-help groups, women’s federations, farmer-producer organizations, and village development committees that are led by the villagers themselves. In March 2020 when the COVID lockdown was imposed, ACF began leveraging these existing ground-level institutions to roll out various initiatives across the country. Create a cadre of paraprofessionalsThe strength of local frontline workers, organized by ACF, has been significant in improving maternal health indicators. During COVID, they oversee interventions and manage the isolated COVID patients by going from home to home every day, recording vitals and other relevant measurements. ACF created a big impact after the COVID second wave began in March 2021 by training additional volunteers in each village to assist health departments with vaccination drives. These local groups of paraprofessionals and frontline workers were effective in addressing taboos, mobilizing for COVID testing, performing home screening, encouraging vaccination, and acting as a general support system to the village. |
What are the lessons learned from this bright spot?
CoviSAINIK vaccine volunteer program
The ambitious CoviSAINIK volunteer effort was launched on World Youth Skills Day, July 15, 2021, to train 10,000 volunteers in COVID-19-related technical skills. ACF, in partnership with King Edward Memorial Hospital in Mumbai, provided technical training to “master trainer” volunteers for COVID-19, who then train the CoviSAINIK youth. As of November 2021, 8736 youth had been trained in villages and are contributing to the vaccination drive. After the training, the volunteers are assessed through an exam and certified on successful completion. Then volunteers are linked with the public health departments and village Panchayats, ASHAs, and auxiliary nurse midwives to support COVID-19-related work.8
As of September 2021, vaccination coverage (approximate) in ACF villages was impressive9:
- 2,600,000 people had been immunized in and around ACF villages.
- Vaccination levels of ACF staff have reached 99 percent at all locations.
- 220 vaccination camps had been set up by ACF.
- 12,229 ACF employees and their families had been vaccinated.
- 7,631 truckers had been vaccinated through ACF vaccination camps.
- 8,730 third-party vaccinations had been given through ACF camps.
Provide a diverse range of support9
ACF’s interventions had a significant impact on the lives of people. To mitigate the oxygen crisis, by September 2021 ACF had installed 6 oxygen plants, donated more than 450 oxygen concentrators, and contributed 60 oxygen flowmeters.
- ACF installed six oxygen plants at Ambujanagar, Gujarat (2), Marwa Mundwa, Rajasthan (1), Ropar, Punjab (1), and Darlaghat, Himachal Pradesh (1), Bhagwanpur, Uttarakhand (1)
- The foundation donated ~459 oxygen concentrators (OC) to each community health center (CHC) and primary health center (PHC). It provided 14 OCs and 445 OCs during the first and the second wave of COVID-19, respectively at Maharashtra, West Bengal, Rajasthan, Gujarat, Punjab, Uttarakhand, Uttar Pradesh, Himachal Pradesh, Andhra Pradesh and Chhattisgarh.
- Out of 130 oxygen cylinders, ACF donated 5 and 125 during the first wave and the second wave of COVID-19, respectively in Rajasthan, West Bengal and Gujarat.
- In Rajasthan, ACF installed 60 oxygen flowmeters.
For more general medical support, ACF contributed this assistance as of Nov 2021:
- Each village was provided with a COVID kit for use by frontline workers or CoviSAINIKs.
- To reach interior villages for maximum coverage, 204 vaccine carriers were given to health departments.
- In association with the West Bengal health department, a “Safe Home” isolation center was set up for COVID patients.
- Additional supplies were sent to many locations, including medicines, stretchers, injectables, PPE kits, masks, oximeters, infrared thermometers, and hand sanitizers, along with community awareness materials such as hoardings, pamphlets, and wall paintings.
In related activities, ACF supported numerous livelihood opportunities during this crisis time:
- ACF supported families, migrants, and laborers with ration kits. The foundation supported more than ~10,000 families with ration kits in Chandrapur, Dadri, Roorkee, Ropar, Bhatinda, Marwa Mundwa, Ambujanagar, Sankrail, Bhatapara, and Farakka.
- ACF collaborated and distributed Ration kits or other food supplies were distributed to 72,000 people in coordination with Goonj, the Praja Foundation, and the Mumbai Roti bank.10
- Nearly 750,000 face masks were made and sold by women.9
- More than 500 women in Sankrail and Punjab started selling vegetables from kitchen gardens in their local markets.8
- More than 800 self-help groups received COVID-19 SAHAY loans (loan scheme of the Government of Gujarat to support local businesses affected due to the pandemic) totaling Rs 4.38 crore ($US 584,000).8
- ACF created a livelihood fund.9
- Zero-interest loans were made available for farmers during lockdown, with over Rs. 2,600,000 disbursed to more than 160 farmers.8
- COVID insurance coverage was given to nearly 24,000 farmers and 384 field volunteers.
How was this promising practice implemented?
Building on their early decision to make full use of local frontline workers, ACF promoted the selection of a single point of contact (SPOC) in each village to assist this frontline effort. A SPOC could be a Sakhi, field facilitator, federation member, village volunteer, or lead farmer.6 All SPOCs are well trained, about both COVID-19 and the crucial importance of spreading accurate information broadly.11 They contribute to the successful COVID response in many ways.
Create an enabling environment for vaccination
Vaccination awareness started in villages in January 2021, with the distribution of IEC materials, images and videos to all SPOCs and community members.11 ACF’s approach to vaccination now includes:
- Running awareness campaigns on vaccination across villages, including announcements through ACF ambulances and e-rickshaws.8
- Engaging with Panchayat members regarding current COVID-19 vaccination levels in their villages.11
- Launching vaccination campaigns in collaboration with the district health department, with mobile vans creating awareness among all villages.6
- Setting up registration desks, building pavilions, drinking water stations, and seating areas at the vaccination centers.8
“With our commitment towards rural communities, we immediately extended our support to our core villages when the pandemic broke out. Our collaboration in the nationwide vaccination program is the next step to contribute to the fight against coronavirus. We believe that our contribution to the immunization drive will help at the grassroot level in rural areas, where people don’t have access to proper health infrastructure and services.” —Pearl Tiwari, Director and CEO, Ambuja Cement Foundation12
Focus on training
For each village, ACF conducted several online webinars and trainings with internal and external experts on COVID-19 for all the staff and more than 3,500 SPOCs. Elected village officials (Panchayat members) participated actively, staying updated on all protective measures and practices.
ACF also provided mental health training support. They conducted multiple sessions with about 3,350 beneficiaries. As of July 2021, more than 600 volunteers were trained. These new volunteers had counseled 71 cases using techniques such as active listening, problem-solving, behavioral activation, using appropriate references, and relaxation techniques to capture mental health issues.8
Create community awareness with social media9
From March through June 2020, about 3,530 SPOCs were signed on and engaged. SPOCS take care of all home-quarantined COVID-19 patients: monitoring vitals daily, counseling, ensuring isolations, making referrals and sharing data with the health system – including counseling to families reduce their panic and anxiety. Every village receives digital awareness content from its own SPOC: mobile phone text messages, specially recorded voice messages, WhatsApp messages, and videos.
From January to September 2021, ACF has raised vaccine awareness in villages using 73 IEC items, 23 photos, and 8 videos. The material helped SPOCs educate community people and spread vaccination awareness with scientific knowledge to dispel fears and myths. ACF liaised with respective health departments for BCC interventions and registered frontline workers.
As of May 8, 2021, the trained SPOCs had reached out to over 650,000 households in 1,902 villages through 3010 WhatsApp groups on a daily basis.6 This included:
- Over 134,000 farmer households
- Over 290,060 elderly population
- 26,000 women in self‐help groups and women’s federations
- 27,840 truckers
- 41,879 MGNREGA (Mahatma Gandhi National Rural Employment Guarantee) workers
- 3,120 frontline health workers
- 115,303 other village beneficiaries
Reinforce COVID-19 messaging
ACF organized a “Let’s Be COVIDIENT” campaign for employees, trainees from Skill & Entrepreneurship Development Institutes, and villagers. This program encourages them to be COVIDIENT: people who strictly follow all health directives and precautions throughout the pandemic. The campaign offers COVID-19-themed placards, FAQs, groups discussions, games, videos, paintings—even photo and video contests.11
Supplementary material
COVID-19 Response by Ambuja Cement Foundation.pdf
Sources
- Ambuja Cement Foundation. Annual Report 2020-21. Accessed on November 25, 2021. https://www.ambujacementfoundation.org/ACF-Annual-Report-2020-21.pdf
- Ambuja Cement Foundation. The Torchbearers: Annual Report 2020-21. Accessed on November 25, 2021. https://www.ambujacementfoundation.org/ACF-Annual-Report-2020-21.pdf
- News Desk. Ambuja Foundation launches nation wide drive to combat Covid-19 pandemic. Everything Experiential. Published April 6, 2020. Accessed October 18, 2021. http://everythingexperiential.businessworld.in/article/Ambuja-Foundation-launches-nation-wide-drive-to-combat-Covid-19-pandemic/06-04-2020-188356/
- Newsletter. Reaching out to rural India in the fight against Coronavirus. I Can-Ambuja Cement. Published April 7, 2020. Accessed October 5, 2021. https://www.ambujacement.com/ican/people/sakhis-and-volunteers-leads-the-way-in-the-fight-against-coronavirus/
- Ambuja Cement Foundation. About ACF. Accessed November 24, 2021. https://www.ambujacementfoundation.org/about
- Ambuja Cement. Ambuja’s Interventions During COVID19. Ambuja Cement Foundation. Accessed October 5, 2021. https://www.ambujacement.com/images/covid_updates/Community_Interventions_on_COVID19_Ambuja_Cement.pdf
- About ACF. Creating sustainable, prosperous, rural communities. Ambuja Cement Foundation. Accessed October 18, 2021. https://www.ambujacementfoundation.org/about
- Ambuja Cement. Ambuja’s Interventions during COVID-19 July 2021. Ambuja Cement Foundation. Accessed October 6, 2021. https://www.ambujacementfoundation.org/uploads/Covid_updates/COVID-19-Interventions-July-2021-Final.pdf
- Ambuja Cements. Ambuja’s Interventions during COVID-19 September 2021. Ambuja Cements Foundation. Accessed December 19, 2021. https://www.ambujacementfoundation.org/uploads/Covid_updates/COVID-19-Interventions-12-10-2021-Final.pdf
- Media. COVID-19. Ambuja Cements. Accessed October 6, 2021. https://www.ambujacement.com/media/covid-19-updates
- Ambuja Cement. Ambuja’s Interventions during COVID-19. Ambuja Cement Foundation. Published May 1, 2021. Accessed October 5, 2021. https://www.ambujacementfoundation.org/uploads/Covid_updates/ACF's-interventions-COVID-19-1st-May-2021-1.pdf
- India CSR Network. CSR: Ambuja Cement Foundation helps over 75000 people receive COVID-19 vaccination in 1900 villages of 10 states. Published May 2021. Accessed October 7, 2021. https://indiacsr.in/csr-ambuja-cement-foundation-helps-over-75000-people-receive-covid-19-vaccination-in-1900-villages-of-10-states/