Staying Alive: COVID-19 and Public Services in West Bengal


This report was published in June 2022 by Pratichi Institute, a Kolkata-based research institute working on themes related to human development such as education and health. It evaluates the implementation of public health services during the Covid-19 pandemic – throughout and after the nation-wide lockdown – in the state of West Bengal. It focuses on programmes relating to child immunisation, antenatal and postnatal care of pregnant women, public distribution of essential food supply and schemes relating to rural employment. The report states that disruptions in essential services during Covid-19 have a long-lasting and profound impact of people’s health and livelihoods, easily transforming an “epidemiological crisis into a huge socio-economic pandemic.”

For the analysis, the report used primary data collected through telephonic surveys of over 2,000 households of West Bengal. These conversations took place during July-December 2020 and the first few months of 2021.

This 194-page report is divided into eight chapters: People's Health during the COVID-19 Pandemic: Public Services and Public Action in Focus (Chapter 1); Opportunistic Methods of Enquiry (Chapter 2); Mother Care, Child Care: Disrupted by COVID Care? (Chapter 3); Health as Security of Food and Livelihood: PDS and NREGS Revisited (Chapter 4); 'No Lockdown for Them': Crucial Role of Frontline Health Workers (Chapter 5); People’s Awareness and Action as a 'Social Vaccine' (Chapter 6); Care and Un-care of Migrant Workers (Chapter 7); and In Lieu of a Conclusion (Chapter 8).


  1. The report surveyed 474 households across 17 districts in West Bengal to understand the status of maternal and newborn health during the first phase of the lockdown in 2020. As high as 59 per cent of the respondents reported receiving help from accredited social health activists (ASHAs) for delivery.

  2. Visits from Anganwadi workers reduced during the lockdown, the report notes. The workers, when they visited, primarily provided nutritional supplements to lactating mothers.

  3. The respondents reported having received cooked food very rarely, even after the lockdown. About 82 per cent had received dry rations after the lockdown whereas five per cent respondents had not received any food.

  4. In 67 per cent of the cases, children’s health check-ups continued regularly during the lockdown. Such check-ups were disrupted in around 20 per cent of the cases, primarily in the districts of Hugli (also referred to as Hooghly), North 24 Parganas and South 24 Parganas. Additionally, 4.2 per cent of the respondents stated that their children have never had any health check-ups at all.

  5. Routine immunisation services for young children suffered during the lockdown. The report notes that many of the respondents were unaware of immunisation schedules. Districts such as East Barddhaman and South 24 Parganas had very low levels of child immunisation during the lockdown, the report states.

  6. One in five households surveyed under this study experienced food shortages during the pandemic. Such food related crises lasted for as few as four to as many as 240 days. A majority of the respondents reported food crises lasting around 60 days. The food crisis among members of Scheduled Tribes was higher than that experienced by any other social group, the report adds. A high percentage of the households that reported suffering from food shortage (29 per cent) were those whose primary source of income was working as agricultural labourers.

  7. Almost 98 per cent of the respondents had ration cards. Those who had ration cards under the Antyodaya Anna Yojana scheme received the highest amount of food grains – 36.8 kg per family. Cardholders under the Rajya Khadya Suraksha Yojana-II received the lowest amount – 14.7 kg per family.

  8. The study notes that the distribution of foodgrain under the Public Distribution System (PDS) did not sufficiently cover the needs of the households. On an average, the PDS provided 29.7 kg of grains to a family per month whereas an average family consumed 47 kg of grains each month.

  9. In order to study the extent of rural employment in during the lockdown, the report surveyed 400 households. Around 81 per cent of these households had job-cards under the Mahatma Gandhi National Rural Employment Guarantee Act, 2005. Out of these, only 55 per cent of the households reported gaining employment under the scheme during the lockdown in 2020. Between April and December 2020, the average number of days with employment for all households with job-cards was only 13 days.

  10. Employment opportunities across districts in West Bengal varied, the report notes. Households in Koch Bihar (or Cooch Behar) received 39 days of employment on an average, whereas only nine days of employment were availed by households in Murshidabad. Beneficiaries of MGNREGA also suffered from delays in payment of wages which lasted for as long as 90 days in some cases.

  11. On an average, ASHAs worked for 8-14 hours every day during 2020, including weekends. Auxiliary nurse midwives and ASHAs were also inadequately supplied with protective gear like face masks, hand gloves and sanitisers, the report notes.

  12. The report notes that poor housing and hygiene conditions in West Bengal proved to be major challenges during the lockdown. Roughly 33 per cent of respondent households had only one room for all members and 11 per cent used shared or public toilets.

  13. As a part of this report, 500 migrant workers from Maldah, Murshidabad and Birbhum districts of West Bengal were interviewed. Most of the workers surveyed were men. About 51.4 per cent were between the ages of 20-29 years. Of all the workers surveyed, 74.8 per cent reported being the primary earners in the family. As high as 93.2 per cent of the respondents lost their jobs during the lockdown and had to return home. About eight percent of them had to undertake the journey back home on foot or by bicycle, in parts or entirely. Around half of the migrants travelled by train but only 22.6 per cent could do it for free. The rest had to spend between Rs. 2,500 and Rs. 10,000 on their journeys.

    Focus and Factoids by Akshita Hazarika.

    PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.


Pratichi Institute, Kolkata 


Pratichi (India) Trust, Kolkata


01 Jun, 2022