Using Public Forums to Dispel Vaccine Hesitancy in Tribal Districts of Madhya Pradesh

“The soul of India lives in its villages.”  Mahatma Gandhi1

Rural areas in India remained relatively unscathed during the first wave of the COVID-19 pandemic, primarily because of low population density, open environment, lower population mobility, and a large proportion of youth.2 During the first wave of the pandemic from April to November 2020, the highest seven-day average caseload in Jhabua was only 34 cases per day, compared with the state average of approximately 2,523 cases per day. However, the second wave from March to July 2021, severely impacted the tribal communities, with a high seven-day average case load of 174 cases per day (five times higher than the first wave).3

The devastation caused by the second wave dissipated any misconceptions that COVID-19 is an urban phenomenon, as the virus rampantly spread to rural areas. A testimony to this was Petlawad, a remote block of Jhabua District (with 136 villages and 69 panchayats) in Madhya Pradesh, where every third villager displayed COVID-19 symptoms.2,4

As of April 15, 2021, only 58,733 (less than 10 percent of the eligible population) people had been vaccinated in Jhabua District.5 Low turnout was driven by misplaced fears of death, illness, or sterility due to vaccinations, which further amplified the crisis of people not turning up for inoculation. District officials therefore decided to revamp an age-old tradition and use the concept of khatla baithak (khat means “woven bed” and baithak means “meeting”) by conducting community meetings to dispel vaccine myths.6 Following this intervention and a set of complementary activities, by July 27, 2021, there has been a fivefold increase in vaccination uptake, with 294,881 (approximately 40 percent) eligible people having received at least one dose.7

How can you replicate/implement this promising practice?

Addressing concerns in public forums: District officials in Jhabua used the traditional concept of khatla baithak (informal community meetings) to address rumors and myths related to vaccinations through a question-and-answer format. Villagers were given space to talk about their misconceptions due to misinformation spread via social media platforms, such as WhatsApp and Facebook. District officials shared their personal experiences of getting vaccinated to instill confidence among community members and made efforts to understand the problems faced by villagers. This exercise helped remove misgivings regarding the ongoing vaccination drive.

What are the lessons learned from this bright spot?

District officials set up vaccination drives in villages to increase coverage; however, due to rumormongering, false narratives were spread, in which vaccines were said to be part of a government conspiracy and could lead to infertility and death.

To overcome these challenges, district officials organized informal meetings, typically used for village elders to sit with residents and settle their disputes. The district magistrate (DM) of Jhabua, Somesh Mishra, took the lead and sat with villagers to answering their queries. He encouraged community members to speak out by sharing his own experience. Rather than an official address, the goal was to have a candid, free-flowing conversation. This interactive format led to positive responses from villagers.6

“The khatla baithaks have been instrumental in helping us reach out to the public and improve vaccination numbers.” — Jaipal Singh Thakur, Chief Medical Officer of Jhabua6

Between March and May 31, 2021, only 50 people had been vaccinated in Mandli village. But once the khatla baithaks began, more than 270 were vaccinated by June 15. Within two weeks, more than 200 people had been vaccinated. Another Jhabua village, Gujarpara, had its first such khatla baithak on June 2. Before the community meeting, only about 10 percent of vials sent daily to the village were used, but the day after the baithak, on June 3, the village saw 100 percent of all vaccination vials that had been sent being used up.

The impact of these informal community meetings on vaccination levels has been apparent. Since the first khatla baithak in early June 2021, Jhabua has reported approximately 4,000 vaccinations daily, compared with 1,800 to 2,100 vaccinations per day in May. On June 24, the district set a record by administering 10,000 vaccines in one day.6 And as of July 27, 2021, approximately 294,881 eligible people have received at least the first dose.7

Khatla Baithak in progress.

What complementary initiatives were in place?

Social messaging in the local language: Officials in Jhabua sought the help of tribal artists to make short films aimed at increasing vaccine awareness. They also held concerts to spread awareness through songs and short films by local tribal artists.7

Fostering collaboration: Nongovernmental organizations supported health workers in remote areas using the following innovative methods:

  • Youth for Children, a UNICEF-supported volunteer organization, focused on raising awareness in the Dhar and Jhabua areas. Volunteers collaborated with medical personnel to organize events and encourage community members to get vaccinated.
  • Members of the Jan Abhiyan Parishad and the Department of Women and Child Development handed out turmeric-smeared rice to rural houses as a traditional means of welcoming people to vaccination programs.9
  • The state government of Madhya Pradesh enrolled 100,000 volunteers from schools and colleges to counsel people regarding their doubts related to vaccines. These volunteers reached out to workers covered by the government's employment guarantee program and encouraged them to get vaccinated.
  • Auxiliary nurse midwives supplied pamphlets that dispelled rumors and provided thorough information about vaccines to inform local communities.10
  • An elected representative member of the legislative assembly proposed a reward of INR 10 lakhs (1 million) for the gram panchayat that met the aim of 100 percent immunization and visited communities to encourage residents to get vaccinated.9

Supplementary material

2. (Jhabua, Madhya Pradesh) Using Public Forums to Dispel Vaccine Hesitancy in Tribal Districts of Madhya Pradesh.pdf


  1. QRIUS. Vibrant villages are key to India’s success. Published January 21, 2018. Accessed July 23, 2021.
  2. Gaon Connection. Rural healthcare, stigma and lack of risk communication have compounded the impact of COVID second wave in rural India. Published May 17, 2021. Accessed July 23, 2021.
  3. COVID-19 India tracker. Accessed September 3, 2021. 
  4. District Jhabua. Tehsil. Accessed July 23, 2021.
  5. Government of Madhya Pradesh. Bhopal. Media Bulletin 15.04.2021. Published April 15, 2021. Accessed August 13, 2021 .
  6. Khan F. An age-old tradition is helping MP’s tribal villages raise vaccination numbers. The Print. June 26, 2021. Accessed July 23, 2021.
  7. Government of Madhya Pradesh. Health bulletin: Covid vaccination coverage. Published July 27, 2021. Accessed July 28, 2021.
  8. Rural resistance to Covid vaccination in MP over rumours of death and impotence. News 18. June 10, 2021. Accessed July 23, 2021.
  9. Singh A. Madhya Pradesh: Covid-19 vaccination picks up pace in tribal districts. The Times of India. July 16, 2021. Accessed July 28, 2021.