Despite significant progress on reducing maternal mortality (MMR), data from 2020 shows that globally, ~800 women died every day due to preventable causes related to pregnancy
In recent decades, India has emerged as a leader in reducing maternal mortality. Over the past 20 years, India’s average annual reduction in maternal mortality ratio was triple the global average, demonstrating strong public health action and political will. Still, India must make significant progress to achieve the global sustainable development goal of 70 maternal deaths per 100,000 live births by 2030. Per 2020 estimates, the Maternal Mortality Estimation Inter-Agency Group, India has an average of 103 maternal deaths per 100,000 live births.
However, the burden of maternal mortality is not equally distributed across India. Rajasthan is among states with a comparatively high MMR of 164 maternal deaths per 100,000 live births, according to 2016-18 data from the Sample Registration System report by the Registrar General of India
The provision of maternal health care in Rajasthan is highly dependent on community health workers (CHWs). The public health system functions as a continuum of care, relying on links between family planning, antenatal care, safe institutional delivery, postnatal care and immunization to improve MMR. CHWs identify pregnant women, collect data that is integral in identifying high-risk pregnancies, and provide antenatal care through maternal and child health camps. In order for this system to function effectively, a strong public health data and reporting system is essential.
Before Khushi Baby started working in Rajasthan, CHWs exclusively utilized a paper-based health records system. This system was highly vulnerable to lost or damaged data record formats, and oversight from primary health centers and health officials was limited to monthly reports that had to be manually reviewed. This system limited the impact of maternal health programs and care in Rajasthan. Without a true baseline denominator, accountability, timely and actionable data for high risk cases, this continuum of care cannot function effectively.
Over the past 10 years, Khushi Baby’s digital solution has reshaped the way that CHWs collect data, identify high risk cases, and deliver maternal healthcare. Khushi Baby’s digital health applications for Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) 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. It 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. Khushi Baby’s application also provides internal data validation, with biometric and GPS used to confirm that CHWs hold MCHN camps and connect with beneficiaries.
Data collected by CHWs in Khushi Baby’s digital health applications is available in real-time for health officials on the Community Health Integrated Platform (CHIP) dashboard. These analytics are a catalyst for timely decision-making
We utilize machine learning to identify high risk pregnancies and connect beneficiaries with life-saving healthcare for mothers and babies. Data available on CHIP is used to calculate a high risk pregnancy score. In Udaipur, where Khushi Baby’s original headquarters are located, Khushi Baby’s field monitors validate high risk scores with ANMs and conduct in-person outreach where it is necessary. Field monitors provide targeted medical advice or referrals to higher-level care for high-risk pregnancies.
