Khushi Baby was a health solution that integrates a mobile app, a digital wearable necklace and cloud computing to track a child’s immunization and maternal health data to the last mile. The specific aim was to track each mother’s antenatal care visit to each child’s immunization within the first year of life in a decentralized, digital, and real-time manner and to motivate better health seeking behavior with our culturally- informed platform.
The specific goal of this project was to improve maternal and neonatal health outcomes by implementing and validating the Khushi Baby (KB) intervention in Rajasthan India. With this grant we look to implement, monitor and evaluate the Khushi Baby system specifically in Udaipur and nearby districts of Rajasthan India.
In Rajasthan, the Maternal Mortality Ratio (MMR) is 244 per 100,000 live births and the neonatal mortality rate (for child under 1 month of age) is 32 per 1000 live births. Rajasthan is an EAG (Empowered Action Group) state, considered a “high priority” state by the Indian Ministry of Health and Family Welfare. Poor health behavior explains these health outcomes. Despite 86% of mothers coming for at least one ANC checkup and receiving their Tetanus shot, only 46% percent of mothers finished 3 of the recommended 4 antenatal care visits. This substantial dropout rate directly affects outcomes at birth.
The current paper based infrastructure used to capture data to identify areas of need not only inefficient, but also outdated. A patient’s data might be uploaded one to two months after their interaction with the health worker; multiple handoffs and errors introduced by the hand calculations of the health workers and data entry operators reduces the quality of the data. Ultimately these millions of patient-specific records are not effectively fed back to the coalition of frontline health workers. When in the field, the health worker relies on referencing an unreliable paper based record to determine a mother’s health progress.
Part of the government’s attempt to rectify this poor system has been to send text messages to mothers, as reminders for immunization camps. Yet, these may not be read or understood by mothers in rural pockets where literacy is low. Udaipur, the base of our operations, is a district in Rajasthan that struggles with these challenges, especially in its rural areas. Antenatal care completion rates are below 40% and immunization timeliness is below 30%.
The Ministry of Health aims to improve its maternal and child health indicators, but must first overcome the aforementioned burdensome paper-based tracking system and weak push-based systems. Khushi Baby can facilitate the transition to a technological medical record. The benefits of the system are multifaceted: it streamlines data collection, attracts attention to the health camp, improves decision making in the field, aids in district resource management, and delivers effective dialect-specific voice call reminders to motivate health behavior among mothers. With the support of ISIF, Khushi Baby strengthened the intervention and continue to conduct trials which provided clear and convincing evidence of these benefits.