Strategies for COVID-19 control among migrant labourers in a developing country setting: Pathanamthitta model from Kerala

BACKGROUND: The ongoing pandemic of Covid-19 is a public health emergency with serious implications world-wide including India. Vulnerable population like migrants are often left out of epidemic preparedness planning and reaching out these marginalized population is a challenge. OBJECTIVE: To describe different strategies implemented for control and prevention of Covid-19 among migrants in Pathanamthitta. RESULTS: Strategies for Covid-19 control among migrant labourers were planned and implemented with intersectoral coordination and community participation. Line listing and risk stratification, mobilisation of community volunteers, contactless active symptomatic surveillance using technology, IEC activities for awareness generation in multiple languages, sample collection, testing and distribution of personal protective equipment's were initially implemented. Setting up of a call centre facility assisted with M health technology exclusively for addressing concerns of migrants was first and one of its kind in the country. In addition to that special measures were taken to improve adherence and wellbeing of migrants which included addressing medical needs of migrants including psychological needs, ensuring food security, migrant hostels for the providing shelter, basic health care, isolation facilities and arranging transportation facilities for more than 10,000 stranded migrants. The success of these strategies was evident from the fact that not even a single migrant labourer was tested positive in the district during this period CONCLUSION: Pathanamthitta district being in a resource constraint setting showed a very effective model by implementing technology assisted strategies tailored to the needs of population.The success of these highly effective and replicable strategy underlines the need to incorporate principles of primary health care in crisis management.