Bihar's Mobile Health Initiative Gains Recognition the World Over

PATNA, India, February 22, 2016 /PRNewswire/ --

Born in Saharsa as Continuum of Care Services (CCS), CCS is a transformative intervention that has already impacted the lives of thousands of women, men and children in the state of Bihar. Simple yet effective, it leverages the use of mobile phones and related technologies by the Frontline Health Workers (FLWs) to address current challenges to improve the health of women and children in a resource-poor setting.

Conceptualized and implemented by CARE India, CCS was co-developed with Dimagi. Having created an evidenced-based impact under the IFHI project, CSS was adopted, by the Ministry of Women & Child Development, who developed upon the model, and now in its improved avatar is known as the Common Application Software (CAS) being used to strengthen the Integrated Child Development Services (ICDS) - another gift to the country from Bihar.

Through CCS, the unreached can be reached by registering pregnant women, mothers and newborn; real-time healthcare information recorded to track appropriate and timely services through the stages of pregnancy, delivery, and postnatal care; and FLWs provided with decision support tools, such as counseling protocols, to improve the quality of health services. It also provides FLWs with tools for scheduling, planning, and coordinating home visits.

Based on the health and nutrition needs appropriate to the stages of pregnancy, post-delivery and newborn care, CCS is an end-to-end mHealth solution, which includes a suite of applications and multiple modules. It aids coordination and integration of services across two key government departments that provide healthcare and nutrition-related services to women and children.

Amidst the Prime Minister's 'Digital India' push, anganwadi centres across the country are set to use IT-enabled services to improve their performance with Anganwadi Workers (AWWs) and officials to be handed tablet devices and smartphones towards that end. Over 300,000 anganwadi centres in 162 districts identified as severely malnourished are set to undergo a strengthening and nutrition improvement project to be launched by the MoWCD with the help of World Bank.

Real-time monitoring of these centres will be done by strengthening them with IT-enabled services. The project will enable the ministry to monitor daily levels of nutrition and supplements being administered to the children. Anganwadi Workers (AWWs) and Sector Supervisors will be provided with smartphones and tablet devices to update data on child nutrition on a daily basis.

Bihar's CCS, in its current advanced form, will be used by more developed states like Andhra Pradesh, Maharashtra, Rajasthan, Uttar Pradesh etc. And, all this was possible, because Bihar showed the way by embracing technology at the grassroots level. Unknown to the country at large, Bihar's ICT-CCS intervention has been recognized in international forums, having received the mHealth Alliance Collaboration Award at the Global mHealth Summit at Washington DC, USA.

CCS has created a continuous and credible digital record of healthcare data, generated at the village level, and made it available to managers and decision makers in real-time. This helps them to not only monitor progress, but also to make informed program implementation-related decisions and provide supportive supervision for increasing reach, quality and timeliness of healthcare services.

CCS, by design, is integrated within the existing public system of health and nutrition-related service delivery. Through training and direct hands-on support, FLWs have found it simple-to-use and easy-to-operationalize. This is evident from high levels of its acceptance by the FLWs and their supervisors.

Use of mobile phone technologies substantially reduces chances of error in recording and transmitting healthcare-related data. Beginning at the village level, CCS enables real-time data recording and availability in a digitized format. This helps to monitor the services provided by FLWs as well as to design-effective healthcare interventions and assist policymakers in long-term planning.

Mobile phones have enhanced the ability of FLWs to deliver quality healthcare services in a systematic and integrated manner. Having the information and tools on their 'finger-tips' has dramatically improved the confidence and decision-making abilities of FLWs, as also their social acceptance and status within their respective communities.

​​​Some significant impacts of CCS on health behaviors viz., Antenatal Care, Newborn Care, Child Nutrition, and use of Family Planning Services:

• ​10% increase in mothers being visited at least two times during their antenatal period by frontline workers
• 13% increase in home visits within a week of delivery to delivered mothers
• 21.1% increase in beneficiaries receiving at least 3 ANCs
• 6.3% increase in consumption of 90 IFA tablets by pregnant women
• 9.1% increase in pregnant women having phone numbers of local transport provider, ambulance, nearest facility and ASHA /AWW 
• 13.7% increase in mother breastfeeding with an hour after delivery
• 7.4% increase in mothers practicing skin-to-skin-care during postnatal care period
• 9.1% increase in children beginning eating solid food at six months of age
• 10.9% increase in mothers adopting modern methods of family planning immediately after delivery

About CARE India:    

CARE India is an international NGO, working for women and girls from marginalised communities. Care India provides a Technical Support Unit to the Government of Bihar. For more information, visit: http://www.careindia.org

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