New Delhi: For a long time, the healthcare workers in India, including the nurses, Accredited Social Health Activist (ASHA), Auxiliary Nurse midwife (ANMs) spent hours filling in lengthy registers to keep records of the patients or families. But a Jaipur-based non-profit organisation, Khushi Baby, is changing the face of last mile community health monitoring in Rajasthan through a digital lens.
The organisation has created a mobile application, ‘Khushi Baby’, with an aim to tie tradition with technology to uplift community healthcare for underserved populations in rural India. The application is used by healthcare workers to file the health records of expectant and new mothers, other patients and their families. It effectively replaces the paper-based registry and eases accessibility to a patient’s health history.
The Birth Of An Innovation
Speaking to NDTV, Dr. Ruchit Nagar, CEO and co-founder of Khushi Baby said that the organisation was a product of a classroom project started by a young group of public health researchers at Yale University and the International Institute of Health Management Research (IIHMR), Jaipur, who were trying to tackle the space of child immunisation.
The team focused on disrupting the process of ‘paper-based tracking systems,’ in which accountability and quality of data were issues.
The team was looking for an area where they could test the solution they had come up with, and they zeroed in on Rajasthan. The team found their initial implementation partner, Seva Mandir, an NGO in Rajasthan providing maternal and child health services to marginalised communities.
Additionally, Dr. Nagar had reached out to 40 professors from several universities in India, following which he got in touch with a former PhD student from IIHMR Jaipur, who is now Chief Operating Officer (COO) and Co-Founder of Khushi Baby, Mohammed Shahnawaz.
How Does Khushi Baby App Work?
The application has several subcategories and widgets- for recording a patient’s history, high risk beneficiaries, pregnancy cases, child cases, post natal cases, eligible couples for family planning, etc. The device also keeps a record of the mother’s blood pressure, anaemia levels, sugar levels, etc. One can also store their biometric information on the device.
An ASHA worker can choose the required widget and fill-in details of the patient and keep its record. The information about the particular patient can be accessed through a dashboard by any ANM worker, nurse and other health officials.
The application is more than just storing the data. It has automated voice call reminders, in a female voice that communicates with these new and expectant mothers in a local dialect. It reminds them that the medical treatments for themselves or the child are due or scheduled. Additionally, it provides educational advice related to health.
The team has also effectively utilised the instant messaging service, WhatsApp, for health officials who are not active on their desktops but on their phones. This is more useful for tracking the reports of high-risk patients, patients who have dropped out of service for quick follow-up and action.
The ‘Khushi Baby’ app also serves as an essential offline health record, as the person can access the digital record without the internet.
The device also has a dedicated module for ASHA workers to conduct a digital health census of their village, capturing sociodemographic and health factors of each beneficiary at the last mile.
Dr. Nagar said that the organisation’s focus of developing the application was to compress the data into a small amount of space.
Healthcare Workers’ Experience With Khushi Baby App
ASHA worker, Seema Kaur from Nandri, Jodhpur, expressed her views on the application and how it helped in her work.
Whatever work we used to do earlier by writing, we are just now a tap away from doing it. If we want to access an individual record, we fill in the mobile number of the person, it reflects the entire details of the person and his/her family.
Ms. Kaur said that earlier she had to carry the heavy register every time she had to visit a family and searching for their health history was a tedious task. Now she carries a mobile phone and can easily cover more families than before.
Another ASHA worker said,
The best part is that there are different widgets in the application, for recording a patient’s history, high risk beneficiaries, pregnancy cases, child cases, post natal cases, eligible couples for family planning, etc. I do not have to keep turning pages, just one tap and it is done.
The application is being used by healthcare workers across Rajasthan, but the organisation has had a successful implementation in Udaipur, where there is a significant tribal population that suffers from malnourishment, anaemia and much more.
ANM worker, Bhawri Chahar details that the application has been a boon for the medical intervention at the primary and rural level in the district.
The app helps me to attend to patients even if I am unable to contact an ASHA worker or other healthcare workers during the emergency times. For example, if I have to attend to an expectant mother with her due date of delivery, and at the same time I am unable to contact an ASHA worker, the details of the pregnant woman are already fed in the application, so I can easily provide her with the treatment.
Role Of Field Monitors In Running The Khushi Baby App Efficiently
Besides the technological bundle of Khushi Baby, there is a team of 13 field monitors, who run the system efficiently. They also help in facilitating high-risk referrals, motivate reluctant parents to bring their sick children to clinics and hospitals to undergo treatments. The field monitors are the medium between the people and the healthcare officials.
The system has been functional with the Udaipur district government since 2017. The organisation studied the impact of their solutions in a randomised controlled trial, by following up on nearly 3,200 mothers in the course of two years.
The team noticed that the Khushi Baby system, with the help of field monitors, was able to improve the children’s immunisation rate by 12 per cent, and decrease the malnutrition rate by nearly 4 per cent.
Once we found out these results, we showed them to the former additional chief secretary and health secretary of Rajasthan, Rohit Kumar Singh, to work with the team and advocate scaling up the solutions, Dr. Nagar said.
Following this, the central ministry of health released the funding to support the scale-up of the Khushi Baby system in about five districts of Rajasthan.
A Field Worker’s Day-To-Day Life
Priya Kumawat, who has been working with the organisation for the last two years, as a field communication lead, spoke to NDTV about the nature of their job. Ms. Kumawat follows up with the high-risk beneficiaries, both children and mothers, and works closely with field monitors and coordinators on a regular basis.
The data of the beneficiaries is registered through ANMs. Once the data is filled in and synchronised, the team receives an online report, which is then forwarded to the field monitors. Following this, the monitors visit the high-risk beneficiaries along with ASHA workers, counsel them about their diagnoses, available treatments, and generic healthcare, and address their doubts.
At present, the Khushi Baby organisation works with over 60,000 healthcare workers and has enrolled more than 18 million beneficiaries in over 35,000 villages.
More About The Organisation
Khushi Baby serves as a nodal technical support partner to the department of health in Rajasthan. Its aim is to build a digital integrated community health platform which covers all national programs. In over five years, the organisation has grown into a 50-member team based in the state, that includes physicians, public health professionals, technology developers, designers, data analysts, and field experts.
About The Founders
Dr. Ruchit Nagar has been recognised as a Forbes 30 under 30 leader in Health Care, a World Innovation Summit in Health Young Innovator, and a Distinguished Young Alumnus by the Yale School of Public Health.
Mohammed Shawnawaz has more than 10 years of public health experience in India, including stints at UNICEF and the National Health Mission (NHM). Shahnawaz has been recognised as a Johns Hopkins Future Health Systems Young Researcher Grantee and a Global e-Health Observatory Laureate.