COVID-19 and Digital Futures: Is India Prepared to Build an Inclusive Way Forward?

As the COVID-19 pandemic forces several sectors into the digital space, India faces the danger of aggravating existing inequalities by excluding large parts of the population.

Has the COVID-19 pandemic accelerated digitisation the world over? A quick Google search shows that there are several white-collar institutions that are considering this question and the future of what the workplace will look like. Many online companies, such as Twitter, for instance, have announced that “working from home” is the future, and have been developing policies to imagine how the post-COVID-19 workspace will look like. Several companies in India as well, particularly in the cities, have been forced to adopt a work-from-home approach too. But are we digitally equipped as a society to handle this shift? The scale of migrant worker crisis that India is currently facing suggests that any kind of digital transformation without building adequate infrastructure in the present is likely to be heavily exclusionary. 

This question of exclusion applies to a larger context as well. As schools and colleges are forced to go online, classes are being conducted over video, examinations have been rescheduled, countless “webinars” have been organised by universities, and some institutions have deliberated on “open-book” tests, indicating that conversation about how to envision the future of education has begun. Education is an “essential,” along with finance and welfare. But not everyone might have the devices or the knowledge necessary to access these facilities remotely. As India’s prolonged lockdown has shown us, bringing the economy to a standstill is detrimental to large swathes of the population. Therefore, any strategy to move forward has to deal with the health crisis and the economic crisis in tandem. The digital space can be an indispensable resource in such a scenario. But it has to be made more inclusive. 

Governments across the world recognise the power of digital infrastructure, and capacity building has been in progress throughout the last decade. In India, the “Digital India” campaign was launched in 2015 in order to make digital services available to the remotest areas. Furthermore, several welfare delivery mechanisms, such as the public distribution system, tried to migrate to the digital sphere. This was done by means of linking recipients biometric information through Aadhaar and PAN to public welfare schemes. But, as several studies have repeatedly pointed out, our digital infrastructure and, indeed, our digital literacy has remained woefully inadequate, particularly in terms of the various dimensions of access. 

In this reading list, we have identified and highlighted some of the problems with digitisation in various essential sectors. 

Education Online

The primary problem with online teaching is the issue of access, as Saumyajit Bhattacharya writes. In his article, he outlines how access does not merely mean the availability of the internet, it also means access to appropriate devices, in addition to privacy. Most students, he argues, attend classes on their mobile phones, where the ability to concentrate for the duration of long lectures becomes limited owing to the size of the screen. Furthermore, such lectures tend to take up a lot of data that students buying limited data packs may not have access to. 

A recent survey done by the University of Hyderabad in the wake of the COVID-19 crisis shows that only 50% students had access to laptops and about 45% could, at best, access internet infrequently and further about 18% did not have internet access at all (UoH Herald 2020). This is the state of reality in a central university. Indeed, the speed of the internet and its fluctuations have seen major problems in many metro cities, let alone rural or small-town India, where many of our students are under the lockdown. In a lockdown condition, stuck within home, there are many corners of one’s living space where data signal is weak. Further, many students do not have unlimited Wi-Fi plans, and have limited size data packs. Several classes in a day can be a substantial cost for many students in the low-income bracket. We know of several instances where students go out of their home in open street corners to access the internet or free Wi-Fi in normal times; even such ironical possibilities are, of course, closed during a lockdown. Thus, however keen they may be, many students are simply not enabled with the infrastructure to take part in an online teaching and learning process. 

Financial Inclusion 

A 2014 survey on financial literacy in India found that only 24% of Indians are financially literate. As Shailla Draboo points out in her article, the Digital India campaign had attempted to achieve financial inclusion through various initiatives like online banking and Permanent Account Number (PAN), Aadhaar cards, and by simplifying tax procedures. Despite that, World Bank data indicates that about 190 million adults in India do not have a bank account, making India the world’s second-largest nation in terms of unbanked population after China. Even though the same report shows that 80% of Indians do have bank accounts, simply having an open account does not mean the account holders will be proficient in using online banking services. 

The most common barriers to the digital financial inclusion include the non-availability of suitable financial products, lack of skills among the stakeholders to use digital services, infrastructural issues, teething problems between various systems, and low-income consumers who are not able to afford the technology required to access digital services (Niranjan 2017). 

Another challenge to digital financial inclusion arises from the attitude of the stakeholders. For instance, take the case of Jan Dhan bank accounts. When the scheme was launched in 2015, banks were given ambitious targets to open accounts for the marginalised. This has resulted in the opening of many dormant accounts which never saw actual banking transactions. 

Access to Welfare

Sankina Dhorajiwala writes that "link fail" is now a common term used across rural India. The term has a diverse range of meanings, from the internet not functioning to an Aadhaar failure.  However, given that in the last decade, welfare programmes have attempted to migrate online for the ease of delivery, “link fail” has become a problem. The application, approval and implementation processes all depend on technological proficiency that neither officials or recipients of programmes have in some cases. Furthermore, as Dhorajiwala writes, there are newer forms of corruption and different ways in which people's rights can be subverted. 

In November 2019, I met Radha Devi in the Rajsamand district of Rajasthan. She is a labourer under the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA). In FY 2019–20, Devi worked for approximately 60 days between April and November, and wages amounting to Rs 12,000 were due to her. After completing her first round of work and seeing her fellow workers being paid, Devi enquired with officials in her village about her wages. She was instructed to wait—she would receive her wages eventually. As per the provisions of MGNREGA, Devi is entitled to 100 days of unskilled manual labour work at a stipulated minimum wage rate on demand. Her wages are supposed to be transferred to her bank account digitally within 15 days of having completed one round of work. If the wages are delayed beyond 15 days, she is entitled to compensation for the delay. Despite these provisions, Devi’s wages were pending for over eight months. Whenever Radha Devi enquired with the bank, she was sent back with the same response: “Wages were not deposited in the bank account.” Even block officials were unable to provide any clarification.

Radha Devi’s situation is not unlike many other MGNREGA workers, all of whose wages are in abeyance. As per the MGNREGA website, her name appears among those whose payments are “rejected.” The reason given was “inactive Aadhaar.” The website neither provides any explanation of the issue nor does it provide steps for redressal.

Healthcare

Aayush Rathi writes that there is little research investigating the existing use, adoption, and efficacy of electronic health records (EHRs) in India. This is true, even for developed countries that have relied on EHRs for some time now. Consequently, the success of EHRs is doubtful. Rathi argues that the success of EHRs is dependent on a number of sociocultural factors, such as the doctor–patient ratio, nature of work, resource constraints that India already has, and technological inability. Furthermore, he writes that the risk of exclusion is inherent in delivering care to remote locations. 

Another major impediment to the adoption of EHRs by health service providers is reluctance on the part of individual physicians to transition to an EHR system. This is because compliance with EHR standards requires physicians to input clinical notes themselves.

Comparing the greater patient load faced by doctors in India vis-à-vis the United States (US), the chief medical officer of an EHR vendor in India estimates that the average Indian doctor sees about 40–60 patients a day, whereas in the US it may be around 18–20 patients (Kandhari 2017). This is suggestive of the wide disparity in the number of physicians per 1,000 citizens in both countries (World Bank nd). Given this, doctors in India tend to be more problem-oriented, time-strapped, and pay less attention to clinical notes (Kandhari 2017). Thus, clinicians will consider a system to be efficient only if the system reduces their documentation time, even if the time savings do not translate into better patient care (Allan and Englebright 2000). The inability of EHRs to help reduce documentation time deters clinicians from supporting their implementation (Poon et al 2004).

 

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