Data Management

Digital divide mars quality of care

The Covid-19 vaccination drive is picking up in Nepal immunising close to 14 percent of the population, but what remains as a perennial challenge is the digital divide. This will eventually exclude the poor and vulnerable who are unable to even fill up the online form for inoculation. Similarly, ineffective management of vaccine certification, especially for migrant workers last month, created unnecessary hassles. The pandemic has exposed and exacerbated the digital divide between the haves and the have nots. This challenge in managing the digital divide will act as an impediment to vaccine access, certification, patient care and data management. Narrowing the digital divide requires careful consideration of the availability, awareness, access and affordability of digital platforms.

Mind the gap

One of the surest means of ensuring the availability of reliable data is having an integrated data management portal or system. The much-hyped and pompous Nagarik app, released by the government in 2019 but implemented in January 2021, could have come to resolve this issue of data management. A well-designed system should have been created whereby all details of an individual, including his Covid-19 status, health status, chronic illness, rate of recovery, medication record and vaccine certification could be integrated. For instance, the Aarogya Setu app in India integrated with the vaccine registration app has made tracing of Covid-19 infected persons relatively easy.

Productive use of social media platforms helps lessen the digital divide by increasing awareness among the masses. Nearly 12.38 million among the 13 million social media users in Nepal use Facebook. Devising a suitable mechanism can integrate an app like Nagarik with the social media accounts of all genuine account holders and bring in more population into the purview of data integration. However, such an app can be made effective only when the consumer is educated about its usefulness as the general public is savvier about using social media than updating information on such apps.

To better integrate information, individuals need to be informed and educated about the value of such an app through well-designed awareness programmes made available on social media. This would help in effectively tracking Covid-19 patients as people are conversant with social media. However, most Covid-19 infected persons are found to be hesitant to share their status. The creation of awareness groups on social media would encourage such people to share the same freely, and this would further facilitate tracing, tracking and treatment processes.

Digital literacy should not be limited to increased access to social media platforms and higher use of apps alone. It should include wider use of digital technologies across all spheres. Sadly, high digital illiteracy persists among low income and less educated users. The harsh reality is that nearly 90 percent of the schools in Nepal do not have digital connectivity and ICT devices for digital education. Even Digital Nepal Framework, 2019 mentions digital literacy as a national challenge.

The current level of digital infrastructure in Nepal is undoubtedly one of the major reasons for the digital divide. The affordability of digital platforms has also remained equally challenging. Our mobile internet charges are the highest in South Asia. Though we do not have precise data, Nepal ranks higher in consumer readiness but lowest in infrastructure and affordability in South Asia. The fact that access to the internet and digital literacy initiatives are confined to urban areas further aggravates the problem.

Issues regarding the inequitable distribution of vaccines across the provinces do persist. Readily available robust data management systems and the mobilisation and empowerment of local representatives could have lessened their severity. Effective implementation of an app requires high digital literacy and access to digital services, whether for maintaining personal records or managing a pandemic. The government has made repeated exhortations, most recently in the budget statement for the fiscal year 2020-21, to increase the quality and reliability of broadband internet service within two years.

However, the expansion of 4G services across the country and the reduction of the digital divide still remains a far cry. Nepal urgently needs one secure and publicly maintained integrated portal that doesn’t infringe upon the privacy rights of individuals. Apps need to be designed by the government for digital data management purposes alone and never to spy or carry out any kind of surveillance on its citizens. They are required to keep benign intentions and safeguard them at all costs. For this, the use and success rate of similar apps also need to be monitored, taking a lesson or two from other contexts.

Reduce paperwork

The policy of the Ministry of Health and Population requiring people to fill up the requisite forms, which are available in both English and Nepali, for vaccination and their verification/certification is praiseworthy. However, the sheer number of documents to be uploaded for verification makes the task cumbersome. By making e-signatures acceptable, one of the several scanned documents that need to be uploaded, namely the confession form that requires fingerprints, can be dispensed with. Proper mechanisms can be devised to obtain feedback about the functionality, user interface and user experience of such online forms, and the necessary modifications can be made to them in a timely manner.

Recently, several migrant workers missed their flights due to delays in the release of their certificates. This could have been averted had the government arranged better service delivery by distributing their certificates on the mere production of their boarding passes with a citizen-centric service orientation. Covid-19 is likely to be around for some time, and the country may need to provide booster doses to the people in the days to come. This requires effective data management, and this will remain a long-term challenge as long as the digital divide conundrum is left unaddressed. New variants of Covid-19 and the impending third wave are expected. Forewarned is forearmed. Merely issuing decrees and protocols will no longer help the country to resolve the digital divide issue. Innovation alone can keep these lurking dangers at bay.

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