8 m-health interventions to improve the lives of Rural Women across South Asia, 1 March 2016

m-sakhi: Mobile Friends with ASHAs
Increasingly the Government of India is looking at ways to leverage the vast reach of mobile technology to address some of its biggest health issues. Last year, IntraHealth pilot-tested an intervention designed to support ASHAs in communicating with and caring for their patients through the use of the mSakhi mobile application.
mSakhi, which means mobile friend in Hindi, is an interactive tutorial that offers 153 key health messages on prenatal and delivery care, postpartum mother and newborn care, immunization, postpartum family planning, and nutrition using a combination of text messages, audio, and illustrations all contextualized with localized illustrations and dialects. Developers created the educational content based on the National Rural Health Mission’s curriculum for ASHAs and sought feedback from ASHAs through a series of focus groups.

AMAKOMAYA: Maternity health & Gynecologist interviews reach to the remotest areas of Nepal

The main aim of ANAKOMAYA is to make pregnant women aware about their pregnancy situation by delivering audio and video content to their simple mobile device in the remotest areas of Nepal. The objective is not limited to delivering multimedia enabled content to pregnant women in the rural and remote areas but maximizing the benefits of Internet services and mobile application by connecting all the concern stakeholders such as Female Community Health Volunteers (FCHV), Local health post doctor, family members (specially HUSBAND of pregnant women) and government District Health Officers (DHO) and making them aware about the situation of each pregnant women and make them responsible to better plan for safe and institutional delivery in rural and remote areas. Animated video has been taken from the baby centers and dubbed in Nepali language. For weekly purpose the project has developed separate videos by interviewing gynecologists. More than 450 pregnant women have already registered in the application and continuously monitoring by FCHV and Health workers.

Living the teenage dream at grassroots with “Stories of Life”
“Stories of Life” is commonly known as mobi-sodes. The idea is to introduce a similar concept like episodes to the young generation in a private mobile screen. Mobi-sodes is a venture to reach out to the young people at their most vulnerable point of time i.e. between ages 13 to 19. NEEDS, intends to address this vulnerability in a positive way by making educative video clippings to enhance the knowledge, skill and information of young people for their informed choice.
Using small video clippings as “Stories of Life” as a tool in communication and development interventions involves: Listening to the concerns of adolescents through formation of young people’s platform. Communicating the messages and supporting information in simple facts for life in interesting and constructive videos that are relevant to a particular context. Dealing with the questions, anxieties, regarding adolescent issues and myths and misconceptions that affect them the most.

Paywast mHealth: Largest Social Network in Afhghanistan
Paywast (meaning “to connect” in Dari), is Afghanistan’s largest social network with more than 1.5 million users. The platform, which stands at the forefront of SMS-based social networking technology in the country – processing roughly 30 percent of all SMS messages – also assists government departments, NGOs, and other enterprises to customize mobile solutions for Afghan citizens. Responding to a low rate of facility-based deliveries and limited referrals, the call center aims to ensure that all women have the opportunity to deliver at health centers with qualified medical professionals by managing customer relationships between patients and community health workers (CHWs), and facilitating access to emergency medical transportation when necessary. Mobile Money Health workers contact the mHealth call center in Kabul to ask for medical information to help them manage cases of obstetric emergencies. For low-risk cases, call center staff provide instructions and suggestions to health workers concerning safe maternal health practices. In high-risk cases, the call center encourages the health worker to refer the patient to a health facility and will provide emergency transport through informal transportation partners (local car or motorcycle owners) to ensure patients go to clinics that provide the appropriate medical services to address their needs. During its first year of operation, the Paywast/CAF mHealth call center enrolled more than 2,000 citizens into the program, of which approximately 65 percent were women. The call center made transportation referrals to more than 1,800 women and their families – all facilitated by mobile money transactions. The center also observed an improvement in the ratio of childbirths that took place in a clinic versus at home in affected areas.
Women Mobile Life Channel
MIRA Channel (also called as Women Mobile Lifeline Channel) is an integrated mobile phone channel to provide health information to rural women and connect them with public health services using mobile phones in low-resource settings. The objective of MIRA is to enable women improve health indicators by self-managing their health and reach towards a larger goal of women empowerment using digital connect. MIRA has multiple sub-channels like Pre-natal care, Child immunization, Newborn care, Family planning and Adolescent health issues with an objective to improve maternal and child health through RMNCH+A approach. Each sub-channel has multiple tools which delivers information to women through interactive edutainment tools by building their knowledge and creating awareness on critical health issues, and ultimately connecting them to the public health services.

Mobile Kunji- Maternity tips in Santhali
Improving maternal health is a real priority in Jharkhand. Despite recent improvements, child mortality in certain areas of the state is shockingly high. To curb this issue, Mobile Kunji (Kunji means a ‘guide’ or ‘key’ in Hindi) is an audio-visual aid used by community health workers to advise rural families about maternal health, child health, family planning and immunisation. It consists of health messages, voiced by a fictional doctor (“Dr Anita”) delivered via mobile phone and supplemented by an illustrated deck of cards. To reach those who needed it most, Mobile Kunji is rolled out in two languages – Hindi as well as Santhali.

Everything about diabetes in 12 local languages- mDiabetes
Arogya World reached more than one million people from all over India with text messages in 12 languages about diabetes and its prevention, and has tested the program’s effectiveness in bringing about behavior change known to prevent diabetes. mDiabetes was designed as a population-level nationwide public health intervention using mobile technology to establish health behaviors known to prevent diabetes.
Messages were provided free to the consumers twice a week for six months. Participants came from all over India and a variety of socio-economic backgrounds. Arogya World then refined the messages, adapting them culturally for Indian audiences based on consumer feedback and review by its Behavior Change Task Force. Nokia Life provided the translation and transmission infrastructure, and transmitted more than 56 million mDiabetes text messages to the consumers throughout 2012.Arogya World assessed program effectiveness by comparing responses of 950 consumers, based on telephone interviews, before and after they received the messages, and also by comparing them with the responses of a similar number of consumers who did not receive mDiabetes messages. Detailed analysis of program effectiveness is ongoing.
Consumers’ awareness of diabetes and its complications increased, and promising trends in behavior change were noted: an 11% increase in daily exercise, a 15% increase in the intake of 2-3 servings of fruits a day, and an 8% increase in 2-3 servings of vegetables a day. The self-reported data are statistically significant. With mDiabetes have helped 150,000 people lead healthy lives.

Conduct 33 diagnostic tests on Mobile through Swasthya Slate
Research and interactions with rural doctors and health care practitioners showed that the real power of mobile based health (mHealth) lies in point of care diagnostics. It is not hard to see the power of your phone or tablet being able to do ECG, measure your heart rate, blood pressure, blood sugar, know the status of pregnant mother, help in monitoring mothers during birth and knowing whether a patient has malaria or dengue.
Swasthya Slate is a powerful device that allows Android Tablets and Phones to conduct 33 diagnostic tests on the mobile device. The Swasthya Slate includes specialized applications that help users perform a variety of screenings and health analysis protocols. It allows users to deliver fast and accurate care at home, in clinics and just about anywhere. It contains decision support tools to enable users to deliver quality recommendations for achieving better health.

The slate stores electronic medical records both locally on the phone/tablet and also pushes the data onto our cloud. This allows offline/online operations and doctor on call services. The tests and diagnostic equipments include ecg, urine, heart rate, blood pressure, blood sugar, blood hemoglobin etc. Swasthya slates have been installed at more than 80 locations worldwide. It has impacted 40,000 lives approximately.
Photo courtesy: www.rethink1000days.org

Author: Digital Empowerment Foundation
Category: DEF, NEWS
Date: March 1, 2016

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