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“ReMiND Me Again” Deploying CommCare to help reduce maternal and newborn deaths in India

ICT4D Conference – Kigali, Rwanda 28 March 2012. “ReMiND Me Again” Deploying CommCare to help reduce maternal and newborn deaths in India. Presentation by: Deepti Pant - CRS India Dr. Neal Lesh - Dimagi, Inc. Project Location. Uttar Pradesh Population 200 million Maternal Mortality

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“ReMiND Me Again” Deploying CommCare to help reduce maternal and newborn deaths in India

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  1. ICT4D Conference – Kigali, Rwanda 28 March 2012 “ReMiND Me Again” Deploying CommCare to help reduce maternal and newborn deaths in India Presentation by: Deepti Pant - CRS India Dr. Neal Lesh - Dimagi, Inc.

  2. Project Location • Uttar Pradesh • Population • 200 million • Maternal Mortality • 345 per 100,000 • Newborn Mortality • 50 per 1,000 • Infant Mortality • 71 per 1,000 • Kaushambi District • Population • 1.6 million • Maternal Mortality • 442 per 100,000 • Newborn Mortality • 59 per 1,000 • Infant Mortality • - 83 per 1,000 KAUSHAMBI Slide 2 of 16

  3. Challenge • Accredited Social Health Activists (ASHA) struggle to provide timely, comprehensive counseling to women throughout the pregnancy and postpartum periods. • Supportive supervision of ASHAs is limited ICT4D Solution • CommCare – an innovative mHealth platform that allows ASHAs to track and support every pregnant woman, mother and newborn Slide 3 of 16

  4. Technology Requirements • CommCare runs on Java enabled phones as well as Android phones. • Minimum requirements for Java enabled phones: • Runs J2ME MIDP2.0 / CLDC 1.1 • At least 2MB Java heap • At least 1MB max jar size • Example: Nokia C2-01 •  Dimagi maintains a central cloud server, CommCare HQ • All data is privacy-protected, backed up, and made accessible to relevant stakeholders. • Accessible through web browsers over the internet. Slide 4 of 16

  5. ASHAs & CommCare – How it works Slide 5 of 16

  6. Example: Counseling on Iron Folic Acid Consumption • Mobile application: “Do you consume Iron Folic Acid?” • Pregnant woman: “No.” • ASHA: Inputs the response in the mobile application and probes for the reasons. • Mobile application describes: • - Where it can be accessed • - Why it is important • - How and when it needs to be consumed Slide 6 of 16

  7. ASHAs & CommCare – Glimpses from the field Slide 7 of 16

  8. Data & Information Flow Slide 8 of 16

  9. Implementation to Date STAGE 1: Preparation of CommCare Applications (April – May’11) CRS & local partner CRS & local partner Dimagi STAGE 2: Beta testing (May-December’2011) CRS, Dimagi, government & local partner Slide 9 of 16

  10. Outcomes & Impact • Global • Published studies documenting how CommCare can improve access, quality of health services • Randomized control study: timeliness of community health worker visits can increase by 86% through reminders delivered to CommCare users. • Kaushambi • ASHAs report that CommCare: • Helps them manage their workload • Improves the quality of their counseling • Increases families’ receptiveness to key MNH messages • Pregnant women report CommCare’s interactive format makes it easier for them to remember key messages. Slide 10 of 16

  11. Future Plans • Joint planning with District and State health authorities to ensure their early buy-in for CommCare and their participation in new content development • Scale-up CommCare with 130 ASHAs in Kaushambi District • Iteration of CommCare applications for: • Facility-based counseling targeting recently delivered women and mothers-in-law, on Home based newborn & postpartum care • Detection and referral of maternal and newborn danger sign • SMS reminders to ASHAs and missed-visit alerts to supervisors • Capacity building of health authorities and communities on the use of real-time data to inform evidence-based decision making • Monitoring, evaluation, and learning Slide 11 of 16

  12. Implementation Challenges • Appropriate time and staffing must be available in the start-up phase to ensure quality iteration of content and initial roll-out of CommCare to ASHAs. • Initial learning curve of ASHAs who have little or no previous experience using mobile phones • Overcoming the perception among some ASHAs that CommCare will increase their workload. Slide 12 of 16

  13. Sustainability Issues • Ensuring continued government support and buy-in for CommCare, including eventual uptake of phone operation and running costs. Slide 13 of 16

  14. Lessons Learned • Successive iterations of application content are necessary to ensure usability on the part of the ASHA and maximize client engagement and understanding. • Involvement of ASHAs in refining content increases their ownership of CommCare • Ongoing Technical Programming and Support Requirements • Retooling CommCare’s reminder technology for the time-sensitive post-partum period. • Back-end support from Dimagi for technical trouble shooting, capacity building and technical assistance to CRS in building applications Slide 14 of 16

  15. QUESTIONS

  16. For Details: Please try the link :  http://www.youtube.com/watch?v=QTjs61L5l2Q Contact details: Neal Lesh – nlesh@dimagi.com Deepti Pant – deepti.pant@crs.org

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