Longitudinal Reproductive, Maternal, Neonatal and Child Health (RMNCH) Platform

Problem

In India, a country of 1.3 billion people, 60,000 mothers and 800,000 children die every year from preventable causes.

India’s public health system has established a continuum of care - family planning, antenatal care, safe institutional delivery, postnatal care and immunization - to improve MMR and IMR. However, a successful continuum of care requires a true baseline denominator, accountability, timely and actionable data for high risk cases, informed care, resource availability, and beneficiary health awareness. But the health system, still dependent on paper-based data collection at the point of care and a mix of siloed digital platforms, is lacking in these key areas.

On a monthly basis, frontline health workers spend up to 20 hours consolidating data into reporting formats and traveling to the primary health center to handoff the format to data entry operators. This process not only deviates attention from providing high-quality care, but also delays timely reporting of data for action. Lack of supervision, burden from multiple health programs, and pressure to meet health targets leads to falsification of health records and underreporting of gaps at the last mile.

In Rajasthan, India’s largest state and where Khushi Baby currently works, is 75% rural and home to over 70 million citizens. The sheer vastness, rugged terrain, and large population of the state presents a challenge to delivering public health. Specifically, with a maternal mortality rate of 199 (India MMR: 130) and infant mortality rate of 41 (India IMR: 34), Rajasthan is a high-focus state with respect to reproductive and child health.

Solution Walkthrough

Solution

Over 5 years, we have created a user-friendly and culturally sensitive digital platform to track reproductive, maternal, neonatal and child health care. Our platform is tailored for last-mile settings with poor connectivity and covers an integrated digital health census, family planning, antenatal care, labor monitoring, immunization and child health.

RMNCH Platform Components

• A continuum of care which connects the village household, sub-centre and primary health center
• A mobile application for healthcare providers, which replaces paper-based tracking, provides prioritized due lists and high risk lists, automates timely reporting of health outcomes and resource shortages, automates direct benefit transfers, and guides clinical decision-making
• Instant, offline sharing of digital medical records, via a Near Field Communication (NFC) health card, at the point of care
• GPS, NFC, and biometric accountability at all points of care. This confirms that 1) health camps were held and 2) the beneficiary met the provider
• Community engagement through dialect specific automated voice calls sent as health camp reminders and health awareness messages
• In-field support to health workers through household follow up visits with high risk mothers and infants
• Actionable analytics and dashboard for health officials for timely decision-making
• Our extensive data sets enable us to build AI models to predict health worker diligence and filter high quality data to predict adverse maternal and infant health outcomes

The Khushi Baby NFC-based health card allows the beneficiary to carry their health record with themselves, allowing for informed care when they meet with their next health provider. For example, a community health worker can scan a child’s health card to instantly see which vaccine is due today, when they otherwise would have to. Additionally, the health provider scans the NFC-card and then the live biometric of the beneficiary. When the live biometric matches the biometric within the NFC card during registration, it is confirmed that the beneficiary was actually seen for services. With this feature, our solution ensures a vital accountability check, which is missing in other mobile health solutions.

Impact

Policy

Ex-Additional Chief Secretary Health, Rajasthan, Mr. Rohit Kumar Singh, vetted, selected, and advocated for the Khushi Baby RMNCH platform to be rolled out across 5 districts of Rajasthan. In 2020, the Central Ministry of Medical, Health and Family Welfare granted 17.55 crore for the project launch under the National Health Mission Innovation budget for the state.