2014

Born at the Yale Center for Engineering Innovation and Design

In his junior year, Ruchit took the course 'Appropriate Technology for the Developing World' - taught by Professors Joseph Zinter and Robert Hopkins at the Yale Center for Engineering Innovation and Design. The objective of the course was to develop innovations to address the world's immunization gap. Ruchit and his team focused on the area of data and accountability, specifically for creation of a digital vaccine record. The first breakthrough came from realizing that Near Field Communication tags could be used to store compressed vaccine records in an offline, battery-free form factor. These digital health records could be viewed and updated by simply scanning the tag with a compatible Android device. Ruchit and team won the inaugural Yale Thorne Prize for Social Innovation, which provided seed funding to field test the initial Khushi Baby system.

2015

Defining the problem

Ruchit was fortunate to connect with Shahnawaz, a then doctoral fellow at the Indian Institute of Health Management Research in Jaipur. With the support of volunteer medicine and public health students, formative work began to design the initial version of the Khushi Baby platform which consisted of a mobile application for health workers, an NFC tag for the beneficiary, and an automated voice call reminder system in the local dialect for the families. The second “aha moment” came from noticing how beneficiaries were wearing necklaces with black thread or kaala dhaaga. By replacing the amulet with the NFC tag, the solution was able to tie tradition with technology and received broad acceptance. Further insights were gleaned from spending a month at the last mile attending daily immunization camps with community health workers in rural Udaipur.

2016

Proof of Concept

Khushi Baby conducted its first randomized controlled trial to assess the impact on timely immunization in the first six months. The initial trial showed promising process outcome results (increased discussion about health camps) but no statistically significant results for the primary outcome. Khushi Baby received a formative research grant from 3ie and support from GAVI, the Vaccine Alliance. This support launched Khushi Baby’s Indian office in Udaipur and facilitated a larger randomized controlled trial on an improved intervention that would digitally track health from the antenatal care period and for community health workers under the government’s National Health Mission program. The two-year, 3200-mother randomized controlled trial demonstrated that the digital health intervention arm had a 12 percentage point improvement in complete infant immunization and 4 percentage point decrease in infant moderate acute malnutrition.

2017

Launching of the Platform

In 2017, after a year of co-designing the platform with health workers, Khushi Baby launched the intervention with the government - a tablet application for health workers, the Khushi Baby necklace for beneficiaries, a dashboard for health workers, and a dedicated field team for hands-on support - in the form of the region's largest randomized controlled trial. The platform also evolved to include automated voice call reminders, an offline biometric authentication mechanism, WhatsApp groups for health worker follow-up, high-risk algorithms, all while being simultaneously evaluated.

2018

Deep Thinking and Promising Impact in Maternal and Child Health

Khushi Baby delved into design thinking during 2018, which was filled with empathy maps and facilitated discussions with mothers and nurses. We were also fortunate to receive cornerstone grants from GAVI and by winning the Johnson and Johnson GenH challenge. By the end of 2018, and some 10,000 surveys later, the results of the trial showed that mothers randomized to areas with he Khushi Baby intervention were 1.66 times more likely to have their infants fully immunized by 12 months and 0.26 times less likely to have their child suffer from moderate acute malnutrition. These results were found in spite of significant financial, technical, operational, and political challenges.

2019

Partnership with the Rajasthan Department of Health

With promising impact results, Khushi Baby approached the Government of Rajasthan’s Department of Medical Health and Family Welfare. The team began advocacy for scale-up of the platform. Khushi Baby's system was vetted against incumbent platforms and ultimately tapped by the Health Secretary as the base for the State's Nirogi Rajasthan Platform for comprehensive community health tracking. Our first project with the Department of Health involved establishing 12 IT-enabled clinics for primary care services, including maternal and child health, in urban slum areas.

2020

Responding to COVID-19

Then Additional Chief Secretary of Health, Rohit Kumar Singh, recruited the team to contribute to multiple digital health projects to support convergence across fragmented digital health systems. Khushi Baby played a formative role in establishing 11 digital urban health clinics launched by the Chief Minister, designing the state’s first digital health census, and implementing the statewide system, to screen for COVID-19 symptoms and comorbidities during the first wave of the pandemic. Our solutions empowered and equipped 50,000 health workers to reach 12 million people across Rajasthan and also included state-wide WhatsApp chatbot, PPE donations, social media and policy support to the Ministry of Health. This effort required modifying the solution architecture for universal scalability, and stepping back from NFC-based decentralization and biometric authentication in the face of hardware procurement challenges.

2021

The Community Health Integrated Platform

By this point, Khushi Baby’s mission had grown from strengthening maternal and child health to supporting primary health care at large. With over 14 million beneficiaries screened through the COVID-19 solution, the team learned to deploy digital health platforms within the government infrastructure at scale, and began working with other primary health care vertical programs. This collaborative effort evolved into what is now CHIP, the Community Health Integrated Platform.

2022

Strengthening our Reach

What started as a group of public health students has grown into a 75-member interdisciplinary team spanning medicine, public health, design, development, data science, operations, and policy, spread across offices in Udaipur, Jaipur, and Bengaluru. Khushi Baby serves as the nodal technical support partner to the Department of Health of Rajasthan for digital health solutions for the community. The CHIP ecosystem has been strengthened by leading partners in both technology and public health. The Ministry of Health and Family Welfare has sanctioned over $15M to support the scale-up of CHIP in Rajasthan.

2023

Scaling CHIP across Rajasthan

After three years of continuous implementation at scale and over 200,000 hours in the field learning alongside health workers, CHIP has grown into India’s second largest digital health platform for comprehensive community health management. CHIP has over 70,000 community health workers and 4,000 health officials onboarded and 40M beneficiaries tracked. This unified platform caters to 14 primary health programs, tracking 800 parameters longitudinally across three tiers of community health provision from household to primary health center.

2024

10 years of Khushi at the Last Mile: Looking Ahead

Looking ahead, Khushi Baby aims to systematize the use of CHIP across programs in Rajasthan, deploy in Karnataka and Maharashtra, further develop the CHIP ecosystem with new integrations with diagnostics, communication platforms, learning management systems, and machine learning algorithms, and to build capacity amongst the Department of Health for big-data driven public health interventions. Interventions will also grow in scope to improve health awareness to beneficiaries through automated community engagement and patient-facing applications. Above all, we believe that CHIP’s primary value will come from alleviating work burden on community health workers, who still spend up to 20 hours monthly on traveling and reporting tasks which could be newly automated with advocacy for a complete paperless transition. Empowering the community health system as a whole will ultimately lead to large scale impact on health outcomes at the last mile.

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