by July 4, 2012 0 comments

With this e-gov initiative, critical health related data of about 2 Lakh mothers and their newborns across 9 districts of 3 states is now available to decision makers

India ranks 1 out of 12 countries that account for two-thirds of children under five and maternal deaths in the world. It is no wonder then that India ranks 73 out of 77 middle-income countries rated for the “Best place to be a mother,” according to a ‘Save the Children’ report that was issued on May 3, 2010. That’s obviously a very sad ranking.

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To reduce maternal and child mortality rates in India, the govt of India have partnered with the govt. of Norway under what’s called the Norway-India Partnership Initiative, short for NIPI. The objective of this partnership is achieve MDG 4, or a reduction by two-thirds in the mortality rate among children under five years. The initiative is being implemented as an integral part of the National Rural Health Mission (NHRM) of India. The mission aims to provide an up-front, strategic, innovative and flexible support to accelerate the implementation of the mission in five states: Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan and Orissa. These states account for over 60% of the infant deaths.

The NRHM has launched the Janani Suraksha Yojana (JSY), which aims to reduce maternal and neo-natal mortality by promoting institutional delivery among the poor pregnant women. JSY is a 100% centrally sponsored scheme and it integrates cash assistance with delivery and post-delivery care. The Yojana has identified ASHA, short for Accredited Social Health Activist as an effective link between the Govt and the poor pregnant women across India. Under this project, data about the health status of mother and child is captured by ASHA workers and later entered in a central system from where it can be accessed for further analysis.

Data is entered at Primary Health Centre level, and earlier, this data entry relied on Internet connectivity as well as a multi record design for each card, in which the best case time for entry was 20 minutes, and the system and database failed often. Analysis was a challenge on account of issues of validations and missing data, and data conflicts and duplication was rampant. The system was unwieldly, yet the analysis required was critical, as it would drive the project, which was for three districts in each of the states of Rajasthan, MP, Odisha and Bihar (and now Haryana).

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The system is important, as ASHA are paid based on these visits, monitoring improves the quality of service, and also identifies ASHA workers who require re-training, and also helps identify issue prone areas across the project area.

The Implementation

A multi-lingual, off-line GUI was developed, which through innovative keyboarding techniques, bit wise data storage, and internal consistency checks enables faster data entry. It takes on average under two minutes to fill a form. Besides this, data size is has also been reduced by over 80% (pre-compression).

Shiv Shankar Kumar, Project Lead

What according to you is the Impact of this project?
Aim of any MIS is to resolve day to day management problem, monitor data and help managers take timely decision. This project too is aligned to do these tasks which ultimately results in healthier mother and child.

How many operators are using this system?
Around 200 data entry operators and managers in 9 districts of 3 states are currently using
this tool for information management and
decision making.

What is the time gap between data capture and data entry into the system?
ASHA worker gives PNC form after 42nd day, and then data entry operator takes 4-5 days to enter data from PNC. This data is cross checked by supervisor which again takes 4-5 days, after this point data moves without any delay.

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Operators are able to batch data and work in separate work-areas, which they define. Their performance can be tracked, and sophisticated consolidation software with sample checking mechanism is incorporated for supervisors.

Data moves up the chain, and at district level, it may be uploaded onto the web portal, which supports two stage imports with import session control, duplicate check, and rollback facility.

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The analysis provides all levels of reports with drill down and statistical and indicator wise reporting. Graphical and tabular reports are supported, and a reporting wizard allows users to draw comparative as well as trend reports.

The Impact

Healthy babies and decrease in neonatal and infant mortality rate is the ultimate impact of this project. With data available for analysis, decision makers can now respond quickly by easily identifying areas where intervention is needed. This system is also used to identify gaps in ASHA workers knowledge and skills and thus required training programs can be conducted if needed.

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