India

Arin Kar

kseaton — Mon, 27 Apr 2020 16:23:51 +0000

Arin Kar Deputy Director of Monitoring and Evaluation kseaton April 27, 2020

Arin Kar is the deputy director of Monitoring and Evaluation at Karnataka Health Promotion Trust in Bangalore, India

India

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Improving the Knowledge of Labour and Delivery Nurses in India: a Randomized Controlled Trial of Mentoring and Case Sheets in Primary Care Centres

cbishopp — Mon, 07 Jan 2019 19:46:49 +0000

Improving the Knowledge of Labour and Delivery Nurses in India: a Randomized Controlled Trial of Mentoring and Case Sheets in Primary Care Centres 2017 cbishopp January 07, 2019

Birthing in health facilities in India has increased over the last few years, yet maternal and neonatal mortality rates remain high. Clinical mentoring with case sheets or checklists for nurses is viewed as essential for on-going knowledge transfer, particularly where basic training is inadequate. This paper summarizes a study of the effect of such a programme on staff knowledge and skills in a randomized trial of 295 nurses working in 108 Primary Health Centres (PHCs) in Karnataka, India.

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https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1933-1

Countries India

Topics Maternal, Newborn, & Child Health Nurses

Publisher BMC Health Services Research

By Janet Bradley, Krishnamurthy Jayanna, Souradet Shaw, Troy Cunningham, Beth Fischer, Prem Mony, B. M. Ramesh, Stephen Moses, Lisa Avery, Maryanne Crockett, James F. Blanchard

mSakhi Is Changing Everything for This Community Health Worker and Her Clients in Rural India

mnathe — Mon, 25 Jun 2018 19:32:23 +0000

mSakhi Is Changing Everything for This Community Health Worker and Her Clients in Rural India mnathe June 25, 2018

June 25, 2018

Digital health empowers Lalita to provide better antenatal care—and to keep up with her children.

Lalita Chauhan starts her day early to the sound of an alarm from her phone. A couple of years ago, she could not have imagined starting her day in such a high-tech way, much less owning a smartphone.

As an ASHA (or accredited social health activist) in rural India, Lalita and other community health workers are benefitting from the country’s Digital India initiative, whereby the national government is transitioning paper-based services to digital platforms to make public services more accessible to communities. Her new smartphone is a result of this, and her confidence in using it comes from technology training from IntraHealth International.

IntraHealth is helping the state of Uttarakhand leverage the national campaign to improve primary health care at the facility and household levels, in part through its mSakhi digital application for Android smartphones.

Now Lalita can pull up real-time status reports for any client, any time on her phone.

To help ASHAs transition from paper records to digital, IntraHealth taught Lalita and her colleagues how to use their smartphones for data collection, skills building, and health promotion. The training also introduces them to new ways to use technology in their everyday lives, such as setting up calendar alerts and wake-up or reminder alarms, as well as communicating with family members and colleagues.

“Hum to abhi whatsapp kar dete hein,” Lalita says—“Now I just WhatsApp.” She can now connect to her friends and relatives instantaneously, she says.

The mSakhi program in Uttarakhand began with baby steps in 2016. For two months, ASHAs and auxiliary nurse midwives were trained in smartphone basics—how to use the Android phones, their features, and different popular apps. Then they learned to use mSakhi for health service delivery.

The data health workers enter into mSakhi are shared among each other and feed into a dashboard that aggregates the information and tracks improvements or gaps in primary health care delivery across the target community.

Lalita says her responsibilities as a frontline health worker have set her free from the monotony of household chores and have helped her pursue a dream of being a professional and earning an income for her family. She takes pride in her mastery of these new technologies, and her ability to access data and demonstrate her knowledge to her clients, building their confidence in her professionalism.

Previously, when Lalita used a weather-worn notepad to track clients in the 250+ households she visits in her area, she missed appointments or lost patient histories in the pages and pages of notes. The records were difficult to organize and impossible to follow over time.

Now, Lalita says, she does not need to remember every bit of this information, because mSakhi does it for her. She can pull up the real-time status report of any client at any time right from her phone, and easily send reports to her supervisors.

The percentage of women who delivered without having had any antenatal care visits dropped from almost 70% to 3%.

Last month, Lalita took us to visit one of her clients, a young woman pregnant with her first child. As we sat down on the earthen floor, Lalita promptly pulled out the client’s antenatal care details and started asking about her health conditions. Lalita scrolled through the app’s interface, eyes fixed on the details as she counseled the pregnant woman on the benefits of proper rest, healthful meals, and timely iron and folic acid tablets—punctuating her points by showing her client pictures from the mSakhi app.

At one point, she opened the counselling section of the app and held the phone close to the client so they could both hear the automated voice giving examples of healthful behaviors toward a successful birth. Occasionally, Lalita paused the audio and added her own explanations.

Smiling at our impressed expressions, Lalita said, “Abhi to sab yaad ho gaya he”—“Now I remember all the things.”

IntraHealth first developed mSakhi in 2012, and has adapted it over time to support frontline service delivery in a number of states and to fit priority needs. mSakhi is new to Uttarakhand. After almost two years of rigorous people-centered design, adaptation, and implementation, the app has begun making its mark on health worker behaviors and on health service delivery.

The percentage of pregnant women who delivered without having had any antenatal care visits has dropped in the project’s target area from almost 70% to just over 3%. The percentage of pregnant women who completed all four antenatal care visits prior to delivering rose from 21.7% to 55.3%.

mSakhi has created a real-time information exchange platform.

Lalita’s story is just one example, but it is very common among the 137 ASHAs working in Dugadda district’s mSakhi project in Uttarakhand. mSakhi has created a real-time information exchange platform, on which responsive decisions can be made and people-centered care becomes possible.

Lalita quips that now she’s waiting for the app to make her child do her studies on time. Her daughter, Himani, is in her final years of schooling, and is Lalita’s biggest fan. She dreams of becoming a doctor in the nearby facility, she says, so that she can follow her mother’s example and serve her community.

By Allison Annette Foster

Former senior advisor for human resources for health, IntraHealth International

By Chayan Roychoudhury

Technical advisor, IntraHealth International

Maternal, Newborn, & Child Health Digital Health Mobile Technology Private-Sector Approaches Quality of Care Community Health Workers India

Photos

Lalita uses mSakhi to counsel Sheela Devi about her granddaughter, Aaradhya, 2.5 months old. Sheela Devi had to walk for about half an hour to bring the baby for vaccinations, including Penta-1 and polio. Photo by Rahul Kumar for IntraHealth International.

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One Health Worker’s Journey from the Poverty Line to the Front Lines of Care in Rural India

intrahealth — Tue, 03 Apr 2018 21:22:12 +0000

One Health Worker’s Journey from the Poverty Line to the Front Lines of Care in Rural India intrahealth April 03, 2018

April 04, 2018

This week, we’re featuring stories from frontline health workers all over the world. It’s just one of the ways we’re celebrating World Health Worker Week 2018.

There’s nothing typical about Kusumlata Bisht. At 40 years old, she is a frontline health worker who has beaten overwhelming odds to find success.

Kusumlata became an accredited social health activist (or ASHA) in 2007. These frontline health workers reach rural communities—and mostly pregnant women, mothers, and children—with preventive health services and information on nutrition, diet, and vaccinations. They are a critical link between rural communities and the formal health system.

As part of her work in the verdant mountains of rural Uttarakhand, Kusumlata has already helped 56 pregnant women plan for institutional deliveries, including escorting them to the hospital; provided assistance at nine home deliveries; and even followed up with two people with severe tuberculosis to make sure they were adhering to their treatment properly.

Kusumlata comes from a poor family—the government had classified them as living below the poverty line. But she has mustered the courage not only to help rural women live healthier lives, but also to use the income from her role to support her own family.

This has brought respect and increased support to the health workers within their families also. Now my whole family is interested in how mSakhi works.

In matters of health, Kusumlata is as much a support to her own family as she is to her village. Her husband is physically disabled and needs ongoing medication for his treatment. He is unable to work outside the home. Kusumlata is also a mother of three, and her eldest daughter has hearing and speech impairments that prevent her from going to school. Despite the needs at home, Kusumlata has ensured her other two children receive a proper education. Her younger daughter is graduating from college this year, and her son is in Class XII about to complete senior secondary school.

To assist with her job, Kusumlata was issued a smartphone by IntraHealth with the mSakhi app. mSakhi, which means friend in Hindi, helps ASHAs and other frontline health workers register pregnant women, plan vaccinations for infants, provide family planning advice, and register new births. It also replaces the cumbersome paper-based registers ASHAs have used to maintain records of families, women, and children.

mSakhi is supposed to make health workers’ lives easier. But, initially, managing the smartphone posed a challenge, as Kusumlata and many other frontline health workers in Uttarakhand had never used this type of technology before. But it has come to be a blessing. As Kusumlata and other ASHAs undertook more trainings from IntraHealth in how to use it, their confidence grew. Now mSakhi is both helping them do their jobs and raising their profiles in their communities and families.

"The IntraHealth team has put in their best efforts to not only help us understand smartphones, but also build our knowledge in the field of health,” Kusumlata says. “This has brought respect and increased support to the health workers within their families also. Now my whole family is interested in how mSakhi works. My husband also helps me in using the smartphone better."

Kusumlata is looking forward to bringing health services to many more families in her community—and to helping her own family thrive.

Read more posts in this series. And join the conversation online: #HealthWorkersCount #WHWWeek

By Sunil Jakhmola

Field Associate, IntraHealth International

By Rahul Kumar

Media and Communications Specialist, IntraHealth International

Maternal, Newborn, & Child Health Community Health World Health Worker Week Community Health Workers India

Kusumlata Bisht, an accredited social health activist in Uttarakhand, India, demonstrates mSakhi on her mobile phone. Photo by Akbar Khan for IntraHealth International.

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Picture It: It’s Vaccination Day!

intrahealth — Fri, 23 Mar 2018 13:28:01 +0000

Picture It: It’s Vaccination Day!

intrahealth March 23, 2018

Picture It: Happy Holi, Health Workers!

intrahealth — Wed, 07 Mar 2018 16:08:01 +0000

Picture It: Happy Holi, Health Workers!

intrahealth March 07, 2018

mSakhi in Pictures

cbales — Fri, 16 Feb 2018 16:41:59 +0000

mSakhi in Pictures

cbales February 16, 2018

February 16, 2018

The mobile app is transforming maternal and child health care in a Himalayan state.

One of the smaller states in India, Uttarakhand lies in the Himalayan foothills with international borders touching Nepal and China. It’s a land of mighty rivers, forests, hills, and mountains. Rich in natural resources, it boasts a variety of flora and fauna, including medicinal plants, tigers, and elephants.

The terrain, striking and beautiful, also makes it hard for people, particularly those in the middle Himalayan ranges, to access health care, including high-quality maternal and child health services.

Many villages like this one are located on mountain tops. Despite the odds—and thanks to India's frontline health workers—registered pregnancies in Uttarakhand have touched 93.8% in rural areas, one of the highest rates in the entire country. When a health worker registers a new pregnancy, the mother gets a Mother and Child Protection (MCP) card, which ensures she receives critical health information and services.

Prabha Devi, an accredited social health activist (or ASHA, a type of community health worker), walks up and down roads every day to reach pregnant women, new mothers, and young children.

Frontline health workers like her are the last bastion of India’s health care system, providing crucial health and nutrition information to women and their families.

They conduct pregnancy and newborn counseling and encourage healthy behaviors, and help identify mom and baby danger signs. They also keep health records to ensure, for example, that children get their immunizations on time, and provide referrals for health services at government facilities.

Today Prabha totes vaccines to Aamsaur village. She’ll soon hand over the carrier to her supervisor Saraswati Rawat, an auxiliary nurse midwife (or ANM).

An ASHA’s load used to be much heavier, and include bulky (and complex) paper registers, checklists, and counseling books. Now that’s all available in an app on her mobile phone.

IntraHealth International created the mHealth application, mSakhi (sakhi means “a friend” in Hindi), to help health workers deliver health care, even up mountains. mSakhi is a job aid, counseling tool, and client register all rolled into one. Frontline health workers like Prabha use the app to teach new moms how to breastfeed and protect their babies from serious illness, and more.

mSakhi helps Prabha schedule and map out her home visits and stay in touch with Saraswati.

Here Prabha uses mSakhi to play an audio clip on home-based newborn care to a young mother. She also tells her about vaccinations at the local health center.

IntraHealth continues to develop and improve mSakhi to meet health needs for people in other Indian states also. Frontline health workers in Jharkhand are using the app to diagnose and manage noncommunicable diseases, for instance. Intrahealth is also building the capacity and confidence of India’s frontline health workers to use mobile technology and capture strong client data.

On a bench outside the village health center, ANM Saraswati gives a measles rubella vaccine to a young boy, as his mother looks in the other direction. ASHAs like Prabha have been putting in persistent efforts to educate moms in the village.

Glowing in the late afternoon light, Saraswati and Prabha flank the other two frontline health workers in Aamsaur village. Families in the community are largely dependent on these gutsy women for their health care needs.

And frontline health workers like them that use mSakhi show better newborn assessment skills, and are more likely to deliver complete messages to clients, including those related to antenatal checkups, anemia, newborn danger signs, and child immunization. That’s definitely something to smile about.

IntraHealth International originally developed mSakhi with support from the Bill & Melinda Gates Foundation. The Margaret A. Cargill Foundation and Medtronic Foundation are currently supporting IntraHealth’s mSakhi work, which was also earlier supported by Qualcomm Wireless Reach.

Photos by Vijay Kutty for IntraHealth International

By Rahul Kumar

Media and Communications Specialist, IntraHealth International

Maternal and Newborn Health India

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Picture It: A Good Example

intrahealth — Fri, 26 Jan 2018 22:48:01 +0000

Picture It: A Good Example

intrahealth January 26, 2018

Picture It: In Ranchi, For NCDs

intrahealth — Fri, 12 Jan 2018 18:48:02 +0000

Picture It: In Ranchi, For NCDs

intrahealth January 12, 2018

mSakhi App Adapted for Noncommunicable Diseases in Jharkhand, India

cbales — Fri, 12 Jan 2018 14:44:02 +0000

mSakhi App Adapted for Noncommunicable Diseases in Jharkhand, India cbales January 12, 2018 January 12, 2018

The Department of Health of Jharkhand, India, is using the mSakhi mobile app as part of its ambitious program to screen clients in Ranchi district for noncommunicable diseases (NCDs) with a focus on hypertension and diabetes.

One in four Indians is at risk of dying prematurely—that is, before the age of 70—from an NCD, according to the World Health Organization (WHO). India is the first country to adapt the WHO’s global monitoring framework to address NCDs by developing specific national targets and indicators to reduce the global number of related premature deaths by 25% by 2025.

mSakhi, which is developed by IntraHealth International, was originally designed as a job aid for frontline health workers in rural India. In Jhansi, which lies in the adjoining state of Uttar Pradesh, hundreds of community health workers called ASHAs (or accredited social health activists) have been using mSakhi to update their skills, stay in touch with their supervisors, and track and report crucial data about health issues in their communities. They also use the app to refer clients to specialists and teach new parents how to protect their babies from infection or dehydration, how to breastfeed, and how to identify symptoms of serious illness.

Prompted by mSakhi’s success in streamlining and monitoring maternal and newborn care in Jhansi, the Jharkhand Department of Health decided to use the mobile app in Ranchi to screen clients over 30 years old for diabetes and hypertension.

Forty-seven ASHAs are now using mSakhi on their smart phones to keep records of clients screened, their results, required treatment after screening, and follow-up visits. These records are being shared with the district and the state health department to help streamline health services.

In a country like India, frontline health workers such as ASHAs are the first defense against health threats in their communities. The primary health services they provide are crucial to addressing NCDs, which kill 16 million people each year.

mSakhi for Noncommunicable Diseases (CAF America/Medtronic Foundation Health Access Grant Program) is funded by the Medtronic Foundation. mSakhi (sakhi means “a friend” in Hindi) is an all-in-one job aid and electronic medical record system that replaces multiple paper-based tools and helps health workers gain access to the most up-to-date training and information in easy-to-understand, convenient formats that work for them. IntraHealth originally developed mSakhi with support from the Bill & Melinda Gates Foundation. The Margaret A. Cargill Foundation is currently supporting IntraHealth’s mSakhi work, which was also earlier supported by Qualcomm Wireless Reach.

Also read: The Case for Frontline Health Workers in Addressing Noncommunicable Diseases Globally

India Noncommunicable Diseases Digital Health Health WorkersIn the state of Uttar Pradesh, community health workers have been using mSakhi to monitor maternal and child care, conduct counseling, and more (above). Now in neighboring Jharkhand, frontline health workers are using the app to screen clients for diabetes and hypertension. Photo by Vijay Kutty for IntraHealth International