What is a playbook?
A playbook includes "process workflows, standard operating procedures, and cultural values that shape a consistant response-the play." it borrows from some of the aristotelian elements of the play -

Plot - The arrangement of events or incidents on the stage. The plot is composed of "clearly defined problems for characters to solve."

Character - The agents of the plot. the people

Theme - The reason for the play. The purpose

3 of the 6 Aristotelian elements of the play


How to make the best use of this playbook

This playbook, Self-Testing in Factories | India: A Playbook for Global Pandemic Preparedness, has been designed to be used in the field by practitioners

You can use the playbook to adopt self-testing measures and guidance not only for COVID-19 but also for any self-test in the future in terms of global pandemic preparedness. The sections can be adapted for any workplace setting such as offices, shops, and other establishments. Given the nature of the activities, the approach is also applicable across geographies and industries.

The logical layout of the playbook, and therefore its independent use in different settings, conditions, and circumstances, is based on the following:

The Why? - Understanding the logic of selftesting and its merits, especially in the context of worker safety, access of workers and their communities to have knowledge about their own health, and an individual’s agency in terms of securing one’s health care. This can be used for advocacy for self-testing in factories. You will find this on pages 3-4 in the chapters Plot: Problem Statement and Purpose and Objective.

The Who? – Recognizing the roles that various people need to play. These could be existing personnel who take up various roles to make self-testing at the workplace a stress-free and smooth process. This can be used to understand the role of the human resource personnel who will need to be ideally deployed. You will find this on pages 6-10 in the chapter People.

The Key Differentiator – Gaining insight into peer-assisted self-testing. The key success factor and differentiator in making the self-testing method work and why it works. This can be used to adapt this approach to different situations. You will find this on page 11 in the chapter The Secret to Success: Peer-Assisted Self-Testing.

Where? – Choosing the right places and addressing concerns about privacy in any health activity setting — whether it should be stand-alone or integrated — is a powerful and valid concern. This helps in understanding the importance of physical space. This can be used to physically alter places or to book suitable places required for self-testing. You will find this on pages 15–18 in the chapter Places.

The When? – Rolling out self-testing successfully in any setting always rests on two axes: Axis 1 – The health-seeking behaviour of an individual; and Axis 2 – The environment that dictates the urgency of self-testing or that enables selftesting. It is also important to take into account the scale at which self-testing is planned to be rolled out. This is a crucial insight that helps reduce panic or stress in any individual, demographic group, or community. This can be used as a rubric or framework to make decisions pertaining to self-testing. You will find this on pages 22–29 in the chapter Act 1. Scene 1. The Planning Phase.

The How? – While the entire playbook is essentially about “The How?”, the logical layout of the sections is, in essence, “The How”. This can be used to design self-testing campaigns and events, or to keep these campaigns and events rolling throughout the year in order to reach out to a specific group of the most vulnerable people or to take a census approach. You will find this on pages 32–67 in the chapters Act 1. Scene 1. The Planning Phase; Act 1. Scene 2. The Pre-Rollout Phase; Act 2: The Rollout of the Self-Testing Phase; and Act 3: Post the Self-Testing Phase and Stage Directions.

Hence, depending on which question you are seeking an answer to in the context of self-testing in the workplace, the playbook is designed to help you as a whole or in parts.


No One is safe till EveryOne is safe

As the COVID-19 lockdowns eased and as workplaces started opening up, worker safety and the early identification of potential outbreaks became important requirements for keeping communities safe. Many industries and sectors that provide essential services such as banking and manufacturing struggled to stabilize themselves due to large numbers of their staff getting repeatedly infected. Gradually, the major industry players, based on epidemiologic indications, realized that COVID-19 was here to stay, and that they needed to prepare the economy and, more importantly the workers, to remain resilient in the face of imminent waves of infection. The two key ways of tackling this issue were to (a) increase the rates of vaccination; and (b) institute policies for regular screening and periodic COVID-19 testing at workplaces. These measures were important for recovery not only to ensure business continuity but also to protect employee well-being and health at all times.

Settings where workers are in close proximity, such as manufacturing units and garment factories, are at particularly high risk of large outbreaks. Typically, these workplaces exist in industrial clusters or informal settlements, and outbreaks in these units can lead directly to outbreaks in surrounding communities, and vice versa. Workers usually hail from marginalised communities such as migrants, daily wage earners, and the urban and rural poor who generally have lower level of access to health systems and health information and who often skip health check-ups entirely to avoid compromising the earning of their daily wage.


The information on self-testing in this Playbook offers guidance to help factory owners, workplace managers, and policy makers explore suitable options for selftesting for vulnerable populations, gather insights into what works and what does not, and deploy communication strategies to address myths and misconceptions. The playbook outlines the steps required for incorporating self-testing activities that can be undertaken for smooth planning and for rolling out the self-testing measures at the workplace.

In the playbook you will find:

  • Set of activities to conduct the vaccination drive
  • Summary checklist
  • Team role matrix
  • Tips and tricks

The playbook divides the entire process into 3 Acts, which are as follows:

  • Act 1
    • Scene 1 : Planning phase
    • Scene 2 The pre-rollout phase
  • Act 2 The rollout of the self-testing phase
  • Act 3 : The post-self-testing phase


Who are the People?

Testing Supervisor
  • Picks the testing strategy and prepares the testing plan
  • Facilitates training and orientation activities
  • Manages the resources required for testing

What does the Testing Supervisor need?

  • Information about the nature and scope of the community spread and the organisational risks for COVID-19, so as to select the most appropriate and most effective testing strategy
  • Assessment of the existing worker welfare policies and of the support systems in place
  • Human resources (HR) schedules and shift details, so as to plan testing properly
  • Technical support in the absence of a health-care provider in the organisation

Who can be the Testing Supervisor in your workplace?

  • HR associate – A person responsible for managing the human resources in the factory/workplace and related compliances.
  • Welfare officer – An individual assigned to support and engage workers in welfare activities in the workplace.

Clinical Team / Trained Welfare Officer:

Who are they: Doctors, nursing staff, or employee responsible for worker welfare

What does the Clinical Team need to know?

If the clinical team members / trained welfare officers are not used to working or interacting with vulnerable populations, it is important to have sensitization sessions on the importance of providing respectful care. At the outset, it is important for the clinical team members / trained welfare officers to discard any assumptions they may have about the information on diseases and health care known or available to workers, or their ability to find this information by themselves. Migrant and daily wage workers may have had negative experiences and hence clinical team members / trained welfare officers should be briefed about answering specific health-related questions respectfully, sensitively, and carefully. During the COVID-19 pandemic, many people did not have access to general health care, even when they needed it most. So if testing initiatives for vulnerable populations are implemented during a pandemic, clinical teams should also use these occasions to address the general clinical concerns of workers and other vulnerable populations.

In this context, it is imperative for the clinical team member / trained welfare officer to carry out the following functions:

1. Provide pre- and post-counselling on what the self-test entails and what to expect.
2. Actively assist the workers in conducting the self-test
3. Ask workers if they have any questions or concerns and respectfully answer or address their questions or concerns, no matter how basic they may seem.
4. Help workers read the test results and address their concerns about treatment and facing stigma or discrimination if they test positive while deploying the protocol on positive test results.
5. Request workers to repeat the self-test the next day if they test negative and if they are experiencing or exhibiting symptoms.
6. Explain the importance of attending routine testing programmes when those who test negative are selected for random testing.

Non-Clinical Personnel: Demand Generation and Post-Test Counselling

Who are they: Unit supervisors or mid-level managers in the factory

What do Non-Clinical Personnel need?

  • Knowledge of self-tests, specifically the ability to perform tests and read results
  • Understanding of the importance of self-tests, capacity to build consensus, and ability to mobilise workers to perform tests
  • Ability to use information, education and communication (IEC) material to create awareness
  • Overview of the testing programme and the ability to coordinate activities with unit heads and the factory management
  • Training to counsel workers who test positive and to coordinate with health facilities to seek and deploy further support
  • Knowledge of how to help workers receiving treatment to complete treatments and reach recovery

Situationally aware management: Anticipate interference and disturbances and have factory management informed and at hand who can handle issues as they come up.

The Secret to Success: PeerAssisted Self-Testing

Why is peer-assisted self-testing important?

  • Presents fewer barriers in communication among peers
  • Circumvents the barriers of hierarchy between workers and their superiors or healthcare providers
  • Represents a buy-in of the intervention by the community for which it is designed
  • Builds a case for point-of-care diagnostics to reach the last mile
  • Allows factory owners to design programmes that suit their workers’ needs.

Peers were selected based on the following criteria:

  • They were recommended by a supervisor or a peer.
  • They possessed strong communication skills.
  • They were quick learners.
  • They had prior experience as peer educators.
  • They had the ability to read and write and to perform data entry.


How to choose the right place to set up peer-assisted self-testing

In partnership with the peers, choose a location for peer-assisted self-testing that is most convenient and safest for them. Identify a location to conduct testing in the factory or workplace. This could be a room or a temporary setup at the workplace, such as a kiosk. The following are some examples of places where you can conduct testing for your workers:

  • Inside the workplace
  • Clinic or medical room
  • Isolation room
  • Conference or training hall
  • Dedicated kiosk set up on the floor of each functional area
  • At the workplace (if it allows for privacy)
  • Outside the workplace
  • Open space with a shelter/roof
  • Dedicated kiosk set up outside or at the entrance

If there are multiple sites or locations in the same workplace, it is important to ensure that all the sites and locations meet the following criteria.

Accessible | Affordable | Available

The testing location should be:

  • Well ventilated — to prevent infection among people taking the test together or in close proximity in an enclosed space
  • Well lit — to ensure that the test is being conducted and interpreted correctly
  • Private — to protect the worker’s privacy while performing the test
  • Accessible — to ensure that all workers will be able to access and perform the test quickly to minimise disruption to workplace production
  • Well equipped — with a flat and stable desk or table to perform the test, chairs without armrests for the workers, and large bins with biohazard waste disposal bags to dispose of the used test kits
  • Accessible facilities – Provision of drinking water, medical care, privacy, washroom.
  • Accessible for people with disabilities. If that is not possible, alternative arrangements should be made. This may involve discussing the matter with the medical officer at the vaccination centre to explore alternatives such as mobile vans.

Learning Vignette

The Learning Finding

  • Initially, we had recommended that at least the sample collection should take place entirely in the open.
  • However, high temperatures and harsh sunlight deterred or prevented peer assistants from remaining outside for long periods.
  • A model for people stepping outside just for sample collection was tried, but the requirement of multiple changes in location for testing, sampling, and data entry led to crowding and confusion and hence proved to be inefficient and ineffective.
  • A new venue, a large and well-ventilated room, was then chosen for conducting the testing events.
  • We noted that while the staff accepted their negative result without much demure or questioning, in the case of those who tested positive and were asymptomatic, some amount of counselling was needed before they were ready to accept the result, specifically if the test line was a faint positive.
  • We also had an event when there was a clear faint positive on the test strip, but due to the lighting in the room, the mobile app picked it up as negative on the first try. On the second try, conducted in better lighting, the app was able to pick up the positive result. However, this led to confusion and doubt about the worker having tested positive.
  • These issues—that result in doubt, uncertainty, confusion, and resistance—will need to be addressed in training programmes for both peers and the management / HR personnel at the factory who are responsible for counselling workers.

The Learning Action

  • Choose a location keeping in mind comfort, convenience, and accessibility in terms of temperature, openness, and ventilation. In some parts of the world, climatic conditions (such as temperature and rainfall) are unpredictable, and it may make sense to perform self-testing activities always in indoor spaces while keeping in mind the requirements for safe distancing.
  • Good lighting is essential to avoid confusion, doubt, or uncertainty about the test result and to prevent (or at least limit) interference with the app’s reading of the results.
  • The lighting should ideally be white light, providing enough illumination for the task at hand, while creating the ambience and comfort you want in a given space.
  • It is advisable to switch on the lights even during the daytime unless the room is naturally well lit.