CHAIRPERSON : Mr Rajiv Tandon, Senior Advisor Health and Nutrition Coalition

PANELIST : Mr Vijya Sai Pratap, Director Business Development, On Mobile Global Limited

Dr Neena Jha initially called out the presenters and the panelists. Most of the presentations were related to infant and maternal mortality and malnutrition issues.  However, the issue of Tuberculosis (TB) was also addressed by one of the presenters.

 Presentations

ARMMAN Arogya Sakhi

Dr Aparna Hegde, Founder and Chairperson of ARMMAN, Arogya Sakhi, spoke about home-based ante natal and infancy care project that is being implemented in Maharashtra.  She spoke about lack of access to information that is a major cause behind infant and maternal mortality in the state.

To address this challenge, the project rural women as Arogya Sakhis who implement the program using mobile phones and internet to provide access to information via SMS and regular home visits.  The Arogya Sakhis are health entrepreneurs who enroll women in their locality  into the program to ensure that no child or woman is left behind.  She noted that while lack of information is a critical challenge, the information has to be presented in a gender sensitive manner, in a repetitive way, and in the dialect that the beneficiaries speak.  The need, especially in rural areas, is home-care after hours where strict monitoring can be done with the woman to ensure that her health and the health of the child are properly maintained.

The results are positive in the sense that more women are being enrolled to receive information.  Based on the information received, women are now more aware of best practices and behaviour.

Vatsalya Mandala

Dr Sushma Taywade, Prime Minister’s Rural Development Fellow, said Vatsalya Mandala works to incorporate GPS and Android based technology in mobile phones for the Integrated Child Development Services to improve the health of children and women, specifically tribal population, with respect to malnutrition.

Dr Taywade explained that the benefit of GPS technology has decentralized information gathering and enabled transparency and accountability of field staff who are working with rural communities.  For example, GPS technology helps senior administration track whether the Anganwadi Workers (ANW) have gone to the village to inspect the child.

Furthermore, all data is captured in real time which replaces the manual system – enabling data decentralization, synchronization and reliable data analysis.  In this respect, she said that often manual efforts led to human errors in capturing data which could not be authenticated subsequently.  With tablet based field visits, data-capturing is simple, reliable, authentic and transparent which helps in auto generating reports.

This approach is helping state level public officials to access quality and reliable data for policy and decision-making purposes.

Peace Nepal Mass Screening

Bidur Raj Joshi, Director, Business Development of Peace Nepal, Mass Screening, presented on the mass screening Application which helps in fighting malnutrition in Nepal.  Mr Joshi screened a photo of Sushma Mukhiya, a child who died due to lack of proper treatment.  In Nepal, approximately 5,000 children per year can be saved from death due to malnutrition.

The online and offline application, where internet connectivity is not compulsory, allows field staff to screen children based on the following category:

• SAM
• MAM
• Healthy Child
• Enroll the child in CMAM program and then follow up

This approach has enabled the program to track the location and the population.  Furthermore, all data is captured in real time which replaces the manual system—enabling data decentralization, synchronization and reliable data analysis.

Swayam Shikshan Prayog, Arogya Sakhi

This program is focused on preventive care as many women are suffering from high and low blood pressure, diabetes, sugar and other cardiovascular or lifestyle diseases.

Arogya Sakhis have received training to mobilize the community who come to the center to get the treatment for a small fee of Rs 150.  The tablet based monitoring enables the reports to be prepared online, and then sent to the doctor for monitoring and analysis with expert comments.  The data is synchronized online for analysis and for proper medical care.

With a small fee of Rs 150, the program can become sustainable. But mobilizing and raising awareness in the community is the most important aspect of the activity which is achieved through the tablet.

National Health Mission, Government of Uttar Pradesh

Mr Giridhari, consultant for the National Health Mission, Government of Uttar Pradesh was representing the program on behalf of Mr Amit Kumar, Mission Director.

Mr Giridhari spoke about the 3G Smartphone technology application which tracks the patient across care and delivery and enables data-driven decision making.  In this service, registration, counseling, pre and post natal care is also done through the application. Based on the analysis, assessment and home-care is also made possible.

Real-time alerts and supportive supervision helps the program bring quality, accountability and transparency in to the process to deliver results.  Mr  Giridhari spoke about the Theory of Change and summarized the results as follows:

• ASHAs use mobile phone and tracking tools
• ASHAs gain knowledge, learn best practices, and provide quality counseling

ZMQ Development, Freedom TB—Mobile Active Compliance System

On World TB Day in 2009, ZMQ Development launched the Freedom TB—a mobile technology initiative.

CEO Mr Subhi Quaraishi explained that TB is one of the leading causes of mortality in India that kills more than 300,000 people every year.  A single patient can infect 10 or more people in a year. But if treated properly, TB is curable. It requires at least 6 months of treatment. Government of India under its TB control programme Revised National Tuberculosis Control Programme (RNTCP) offers free treatment and medicines at various health centres and government hospitals.  DOTS (Directly Observed Treatment Short Course) is a strategy recommended by WHO. It is the only effective means of TB treatment and is practiced in more than 180 countries.

UNICEF Assam

Mr Ajitkumar Kisanrao Sudke, Health Specialist, UNICEF Assam spoke about how ICT solutions which includes real time monitoring using mobile phones is being implemented in Assam to address gaps and build the health systems in the state.

Assam is a state in India that has the highest maternal mortality rate.  Based on open source technology and partnerships, the UNICEF Assam team has done assessments around maternal health in Assam and beyond Assam in Bihar.  The most interesting and fruitful approach the team took is building partnership with medical colleges and universities.  Medical students under the supervision of the professors undertook assessment in the state which gave them real exposure to the challenges and the possible solutions in a more transparent, accountable and systematic manner.

This was a unique program which gave real-time data to the team in the headquarters—enabling quality information and analysis for decision-makers at the central level in the state.  This is updated live on the website, said Mr Sudke.  This approach is being considered for introduction in more states in the country.

Closing Remarks

Mr Rajiv Tandon, Senior Advisor at Health and Nutrition Coalition said that there is a need to improve quality of access and information for the last mile beneficiary in rural and urban areas.  He further elaborated on the need to incorporate IT into the health infrastructure to expand benefits and improved health outcomes, but further questioned, what types of tools will be incorporated and how?

Mr Tandon said that the focus or the question should be on effectiveness and cost-effectives in program delivery, as most of the presenters paid attention on how mobile phones were enabling quality tracking and information gathering for data analysis for better decision-making.  He said that India is not going to achieve the MDGs and there has to be real value add for each stakeholder.

He concluded that each stakeholder must come together to share what value addition it can bring.  Specific to IT, there is a potential for negative information to spread—so in that context, it is necessary to have multi-stakeholder approach.

Ms Neena Jha presented the certificate to each presenter for their contribution to positively impacting maternal health outcomes in India.  She said that to further bring positive benefits, there has to be right intentions with right passion with the right mixture of technology—not just technology.