mHealth Solution To Support ASHA Facilitators For Maternal

m-Health Solution To Support ASHA Facilitators For Maternal Health & Child Survival Low Cost – High Returns Fourth National Summit on Good, Replicable Practices and Innovations in Public Health Care System in India, 06 – 08 July, 2017, Indore

Scope of Project History/Key Milestones Project Snapshot 2014 – NHM creates ASHA Facilitator Cadre Uttar Pradesh Asha Sangini : 6815 Asha Worker : 160175 2014 – ASHA Sangini Application on Supportive Supervision launched as pilot under Project ASHA Workers covered : 257 Partners : NHM, DOHFW, NHSRC, CRS, DIMAGI Re. Mi. ND 2016 – 3 new Forms launched: ASHA Drug Kit Tracking; Maternal Death Reporting; Infant Death Reporting Scale up HPDs: Barielly; Faizabad; Kannauj; Mirzapur; Sitapur Estimated Population : ~ 1. 77 Cr NHSRC led Multi state workshop conducted 2017 – Scale up to 5 High Priority Districts included in PIP ASHA Sangini covered in Pilot (Kaushambi + Bakshi Ka Talab, Lucknow) : 79 Current Pilot Scale Up ASHA Sangini : 523 ASHA Worker : 11, 840

ASHA Sangini Supportive Supervision Program Capacity Building of ASHAs ICT Block review meetings • • Cluster Meeting ASHA Registration Expected ASHA beneficiaries ASHA Functionality Grievance Redressal Maternal Death Report Infant Death Reporting ASHA Drug Kit Tracking • Drive coverage and quality of service delivery • Developed with joint consultation of NHM & NHSRC • Use of Mobile phone ICT to improve effectiveness and efficiency of Supervision • Based on guidelines outlined by the NHSRC in the ASHA Facilitator Handbook – 10 Functionality Indicators; Formats 1, 2, 3, 4 &5 • Would cost less than • similar intervention with ASHA Workers at scale • Comprehensive approach involving strengthening supervision platforms by use of ICT data Improve ASHA Functionality Enabling Grievance Redressal • ASHA Sangini equipped with Android phones and recharged with a data pack Data hosted on Dimagi’s Comm. Care open source platform

A Quick View of the Application

ASHA SANGINI VISIT FORM (FORMAT 1)

ASHA SANGINI WISE COMPILED REPORT OF ALL ASHA SUPERVISED (FORMAT 2)

CONSOLIDATED ASHA FUNCTIONALITY QUARTERLY REPORT (FORMAT 4)

BLOCK-WISE ASHA PERFOMANCE REPORT ON FUNCTIONALITY INDICATORS (FORMAT 5)

Outcomes Kaushambi October ’ 14 – June ‘’ 17 • 39% increase in proportion of ASHA Sanginis who guide ASHAs in tasks they could not complete the previous month • 52% increase in proportion of ASHA Sanginis who discuss with ASHAs their coverage of marginalized community members • 41% increase in ASHA Sanginis who provide feedback to ASHAs on the areas of improvement that she observes during her visit Source: Re. Mi. ND Application

Benefits of the Application Ø Improved Supervisory approach Ø Improved focus on reaching marginalized communities Ø Timely reporting of maternal and child deaths Ø Facilitated timely payments and drug kit replenishment ØIdentification of poor performing ASHAs – who need additional support and repeated visits Ø Transparency of data across at all levels of reporting

Way Forward Dashboard • Scale up to 5 HPDs • Transfer of dashboard to the government for adaptive programming • Integrate ASHA Sangini Application with BCPM ICT platform being developed • Exposure visits and engagement with other states interested in rolling out ASHA Sangini app on supportive supervision

Scalability Ø Cost effective tool Ø Makes it feasible to reach out to all ASHAs through ASHA Facilitators (20 ASHAs per AF) Ø Designed in compliance with Community Process guidelines Ø Simplicity of application – ASHA Facilitators find it easy to use / works on offline mode Ø Application can be adapted and used by states Ø Comprehensive ICT and Non-ICT (systems strengthening) interventions can drive improved Health Outcomes

3 Estimated cost to government of scaling (per 100 ASHA Sanginis) State’s Cost (In Rupees) Procurements (mobile etc. ) Communication/data pack Training/workshops Data hosting Total cost of 100 AFs (Y 1) 647, 000 150, 000 755, 950 65, 000 1, 617, 950 Total cost of 100 Annual cost for year 3 AFs (Y 2) and onwards 60, 000 180, 000 396, 450 78, 000 714, 450 Technical support costs 120, 000 180, 000 0 78, 000 378, 000 (Techno-managerial support at field, app and dashboard customization, project management, master trainers, state level review meetings etc. ) ASHA coverage : approx. 2, 000 Population Covered: approx. 20, 000 – 30, 000

Thank You