2016 ANNUAL REPORT

Dear Khushi Baby Family,

This past year at Khushi Baby has been one of tremendous growth, learning, and opportunity.

● We established our headquarters in Udaipur● We completed our first randomized controlled trial and enrolled 3000 mothers, across

600+ villages, for our second trial● We secured our first government partnership with the Udaipur District Health Society, to

implement the new Khushi Baby system● We rebuilt our technology platform from the ground up to meet the demands of scaling

through a national health program

Our team has grown from 5 part-time members at the start of the year to 9 full-time staff, 5 part-time staff, 9 summer interns, and a field team of over 30 surveyors. Our community of partners around the world has even more so expanded our reach and potential, by providing catalytic funding, mentorship, and introductions to key decision makers who can take us to scale.

We’ve boldly set out to reinvent the health record - our mission, to make a digital record for life, for all. The Khushi Baby experiment has lit a spark from Silicon Valley to the rolling Aravali Hills of Udaipur. Our metrics suggest we have built something that can be adopted and retained; that our system can breed efficiency and transparency; and that our field-ready solution has great potential to catalyze community engagement towards maternal and child health.

After a year of evaluation, reflection, iteration, and preparation, we could not be more excited to launch today. For us, our method has been to focus on the process: research, design, community engagement, technology, and business development interweaving in a way that makes our innovation viable. And now, the journey ahead requires of us not to go the extra mile, but to go to the last mile. We welcome you to join us on our journey to ensure each mother and child receives the care they deserve.

~Team Khushi Baby (09-Feb-2017)

1

3

Ruchit NagarCEO

Mohammed ShahnawazCOO

Preethi VenkatCRO

Tanooj LuthraCTO

Bhupesh NagarTechnical Program Manager

Vijendra BanshiwalProgram Manager

Pawan SinghProject Associate

Hamid AbdullahProject Coordinator

Deepa ManjanathaResearch Associate

Logan StoneResearch Editor

Farhana JamalCommunications and PR Staffer

Robert HopkinsAdvisor & BoD, Yale

Joseph ZinterAdvisor & BoD, Yale

Martin KleinAdvisor & BoD, Yale

Blair PalmerAdvisor, UNICEF Innovation

Shail SinhasaneAdvisor, Mobisoft

Zeena JoharAdvisor

Fabio SergioAdvisor, Frog

Mariano CucchiAdvisor, Frog

Li ZhangProgram Manager, Gavi

Sukumar SalokheTechnical Program Manager, Mobisoft

Hemant ShindeTechnical Program Consultant, Mobisoft

Jitendra KolateLead Android Engineer, Mobisoft

Rishi RawatLead Backend Engineer, Mobisoft

Sowmya NarraLead QA, Mobisoft

Gurudeep SachanTechnical Program Consultant, Mobisoft

Demola AdewumniProgram Manager, Cradle Brooks Nigeria

Field Monitors:Arjun SinghDhanwant KumarSunder Lal LoharNavratan PargiSurya Prakash PagariyaPrabhulalSukhlal DungariGanpat Kumar SalviRakesh SharmaLaxmi lal MansaShravan Kumar JogiPrakash Chandra ParmarDenny KumarBhupendra Singh ChouhanPrakash BaderaPrem Shankar

With special thanks to alumni:Doma Sherpa, Sanjana Malhotra, Daniel James, Olaide Ojewale, Archa Misra, Uzma Maryam, Tarun Singh, Mahender Singh Bhati, Shankar Singh, Ujjwal Anand, Nishant Jain, Sara Locke, Harshal Patil, Saeed Shaikh, and Tyler Petrochko

Khushi Baby Inc. is a registered 501c3 in the United States founded in May 2014.

Khushi Baby Association is a registered Section 8 Company (non-profit) in India founded in 2016.

123 Kharol ColonyFatehpura, Udaipur 313001Rajasthan, INDIA

team@khushibaby.org

4

DesignTech

Public Health

Field

Our Mission is to motivate and monitor the health care of mothers and children to

the last mile

We tie together tradition with technology...

We connect and translate

...to make a Decentralized Digital

Key so that communities in need

can access health and social services

5

15,000 vaccinations

tracked

Khushi Baby is a wearable solution to

digitize health records and

decentralize the provider-patient

interface, anywhere in the world

2.5 years old

$500KRaised to date

2RCTs

3 Parts to the Platform

1. The Android Application for Health Workers

2. The NFC necklace as a health record for our patients (mothers and children) - it is culturally symbolic, waterproof, costs less than a dollar, and uses no battery

3. The KB Dashboard for Health Administrators with ANM performance, maps and gaps, automated reports for upload to the State Database, patient-level health data, and automated voice call reminders.

6

How it works

Record Scan Sync Analyze Engage

At the beginning of last year, we realized we would need to return to the drawing board for our platform. Our app only covered child immunizations. As a result, Seva Mandir nurses still had to take out their log book for pregnant mothers coming to the same health camps for antenatal care checkups.

We approached the CMHO of Udaipur, Dr. Sanjeev Tak, with a rough Proto.io mockup of a proposed maternal health module to be layered on. He responded by laying down the gauntlet - the National Health Mission’s Reproductive Child Health Register. He told us to read it from cover to cover, and ensure that our application included each and every requirement outlined by this Government Bible for over 2.5 lakh (250,000 ANMs) in India.

We meticulously documented each unique field from the RCH register, adding additional data columns where data could be more complete, and removing redundancies along the way. We wireframed, paper-prototyped, defined schemas, and started building - from scratch. We explored new wearable form factors, for the mother, looking to symbolically tie the health of the mother with the child. And we did this all with regular interaction with our complex web of stakeholders: mothers, Auxiliary Nurse Midwives (target app users), Lady Health Volunteers (ANM supervisors), Data Entry Operators, Health Administrators, and Accredited Social Health Activists (ASHAs) who coordinate with ANMs to get their feedback.

In order to truly empower our frontline users, we will continue to keep design at the forefront of what we do at Khushi Baby. We look forward to deepening our design expertise in house, and with the communities we serve.

7

8

What’s new in KB 2.0:● A Maternal Health Module● NHM Standards● Mother-Child NFC Link● High risk alerts● Smart due-lists● Biometric Log-in● NFC Backwards compatibility● A new hardware platform● Actionable Dashboard

60+ versions

800+ columns

1100+ files

92,000+ lines of code

What to expect in 2017:● Vaccine stock linking● Child face biometrics● Biometric authentication on NFC tag● Direct upload to Govt Registries

Tech

9

Research to Date

In the Summer of 2015, the Khushi Baby system was piloted in a cluster Randomized Control Trial (RCT), conducted in 96 village health camps. These camps are serviced by Seva Mandir, an Udaipur-based NGO that graciously invited us to test out our system in their rural immunization camps. The target population for this study, composed mostly of agricultural laborers and some migrant workers, included those living in rural regions of Udaipur, Rajasthan who fall into the lowest socioeconomic status (SES) category of the country.

Our objectives were to determine the effectiveness of the Khushi Baby system in improving immunization adherence, and to quantitatively examine secondary outcomes that indicate whether the KB wearable promotes discussion, is better retained than paper immunization cards, and is well liked by mothers. Though camp attendance rate and immunization adherence results were null (potentially due to low power and short term follow-up), the necklace was well retained by the community (FIVE times better than the paper MAMTA card), suggesting that it could be a valuable social symbol and community engagement tool. The use of a culturally appropriate wearable as the data collection tool also amplified discussion around the KB system within the community, but little impact of the voice call reminder system was evident as call deployment was inconsistent. KB reduced time to sync reports from the field from 1 month to 2.5 days.

RCT 2: Onwards and Upwards

Khushi Baby is on to phase two: expansion, refinement and integration. We are currently conducting our second randomized controlled trial with the help of the International Initiative for Impact Evaluation (3ie), in over 600 villages in Udaipur. Our system will touch over 30,000 mothers and children, tracking not only child immunizations, but pre- and postnatal maternal health outcomes as well. We are looking to analyze the KB system’s impact using the data gathered (via survey and KB Dashboard) and in regards to a series of health outcomes as well as a collection of procedural efficiency indicators. We are confident that this next step, in addition to our partnerships with UNICEF and Gavi, can lead us to full-scale government integration at the state and country levels in India and beyond.

10

The biggest benefit is that at the Primary Health Center level, patient’s full records will be available. There is a biometric system to check attendance. There is a GPS system to also see who went to which camp and to confirm the location. Finally, the data will go to our dashboard from the field on the same day.

So we have been working, and Khushi Baby has been working for the past year. We appeal to you all to give them your full support. It is a joint venture. We are both coming together to do this work”

- Dr. Sanjeev Tak

Chief Medical Health Officer, Udaipur District11

“

Nurse trainings and feedback sessions with Pawan Singh, Md. Shahnawaz, and Vijendra Banshiwal

12

13

Summer 2016 marked Khushi Baby’s second iteration of its Summer Internship Program. The goal of the program is to offer students (both graduate and undergraduate) and professionals from various fields an opportunity to gain hands on experience in work such as public health field research, app and backend design, managing data and more. Our interns have come together from across the globe at Khushi Baby Headquarters in Udaipur, Rajasthan, bringing their diverse skill sets to propel forward the company’s unique objectives at the intersection of global health, technology and social entrepreneurship. This past year welcomed 9 new interns.

14

Khushi Baby provided me with an opportunity to gain hands on experience with implementing a public health intervention in the context of an evolving global health startup. Trips to the field were undoubtedly the most powerful part of the experience because they were opportunities to see some seemingly abstract ideas, such as brainstorming a survey for pregnant women and mothers, become a reality. For example, discussing the baseline survey at KB HQ was a completely different experience than actually piloting the survey out in the field with pregnant women and mothers. I was able to both appreciate the challenges community health workers face when conducting a qualitative survey of this nature, and to learn how to more aptly address these challenges by modifying the survey to make it viable in the field.

- Farhana Jamal, Research Intern

15

One of two Winners of the Challenge by UNICEF, ARM, and Frog out of 250

Applications from 46 countries

One of the Top 100 Social Enterprises of 2016;

presented at the Classy Collaborative in Boston

One of the seven Pacesetter Innovations for increasing uptake, scale, and equity of

Immunization. Selected by GAVI to be supported for Country-wide Scale-up out

of 80+ applicants

One of eight Digital Trailblazers in India, representing the State of

Rajasthan, awarded by CM Rajasthan, Vasundhara Raje and Union Minister of IT, RS Prasad

16

Recognized as one of 100 of “the world’s most inspiring examples of tech for good”

in 2016

Awarded Technical Innovation Award for

Scale Up

Khushi Baby Team with Hon. Union Minister of Information and Technology, Ravi Shankar Prasad, being presented with the National Digital India Trailblazer Award in Delhi

17Khushi Baby Team with Hon. Chief Minister of Rajasthan Vasundhara Raje, being presented with the Rajasthan Digital India Trailblazer Award in Jaipur

Ruchit was selected as one of Forbes 30 Under 30 for Health Care and Forbes 30u30 Asia in 2016. He presented at the inaugural Fortune Brainstorm Health conference , where Khushi Baby was recognized as one of three “Wearable Sensors that are Saving Lives”

18Winner of the Startup Festival Udaipur, Tech4Raj Innovation Track. Doma Sherpa and Md Shahnawaz receive the award.

Selected by Cisco as One of 15 “digital disruptors” out of

5500 applicants from 150 countries

Selected as a Finalist for the Not Impossible Awards. Not Impossible in partnership with the United Nations Foundation recognizes people, companies, technology, and transformational

inventions that are helping bring positive change to the greater global community.

Ruchit was the Recipient of the New Professional Award recognizing the career

of an alumnus who is a promising professional in the field of public health.

19

3 New Grants ($128K)

2017 is shaping up to be an inflection point for Khushi Baby.

KB was showcased as part of the GAVI INFUSE update at the World Economic Forum on January 17th.This week we launch our system across 300 villages. Key stakeholders will be invited to see in-field demos of the live app in Q1.

Our goal is to scale our platform as a service as the preferred system for the Government of India’s Reproductive and Child Health program by the year end. By the end of Q3 we plan for roll-outs in at least 3 additional districts across multiple states in India, and in pilot districts in Nigeria

To help realize our vision, we look to bring new skillsets to the KB team: government relationships managers, EMR integration experts, and designers. We will leverage our growing partnerships to scale-up manufacturing and software development with Mobisoft and Safran. New partnerships with telecom providers may prove to further catalyze our growth.

Next year is all about executing in the field and building traction. Our hands-on experience with delivering the end-to-end solution from conception to implementation gives us a niche expertise when it comes to scaling the KB system to reach more nurses, more mothers, and more children for a broader impact. But above all, we have to demonstrate the upshot of our paradigm shifting approach to field of global mHealth.

20

We entered the UNICEF Innovation Incubation program in the first half of 2016, after winning the Wearables for Good Challenge. UNICEF Innovation has assembled an international cohort of partners to support us in our efforts to transform into a social enterprise ready for scale, while connecting us to in-country offices and with international influencers

ARM supported Khushi Baby through the Wearables for Good Process and Incubation, providing critical funding which has enabled the development of KB 2.0

Frog supported Khushi Baby in Design Strategy, with a particular focus on form-factor and paper prototyping

GAVI tapped us as one of their 2016 INFUSE Pacesetter Innovations for uptake, scale, and equity in immunization. GAVI brings capital, expertise, and networks to bring our innovation to scale

Safran Identity & Security has been our key technical partner for hardware and biometric services

Mobisoft is our key technical partner for software development services

21

Our platform is modeled off all requirements outlined by the National Health Mission Reproductive Child Health Register

Udaipur District Health Department Is the first Government partner to launch the Khushi Baby platform

KB was awarded the National Digital India Trailblazer Award by Hon RS Prasad

3ie awarded us with their Rapid Impact Evaluation Grant and works closely with us on the research design, policy, and communication of our evidence base

Khushi Baby was born out of the Yale Center for Engineering Innovation and Design, launched by the Thorne Prize, and grown at the Yale School of Public Health

Khushi Baby works with advisors affiliated at the Harvard Medical School on developing paths for scale up and new use cases in public health

22

ISIF Asia awarded us with their Technical Innovation Award

As part of the ISIF Asia we had a chance to participate in a 3 week accelerator with JFDI; they linked us in to the South East Asia social enterprise and venture philanthropy networks

Khushi Baby is member of the Harvard I Lab Venture Incubation Program

Seva Mandir was our first field partner, with whom we conducted our first Randomized Controlled Trial

Go2Tags has been the preferred NFC tag provider for the Khushi Baby wearable

Cooley has provided pro-bono legal support and consultation since 2016

Andela provided pro-bono development services towards the mobile and web app development of KB 2.0 through August 2016

PCH International provided pro-bono consultation on manufacturing and scale-up during the UNICEF Incubation period

23

Twilio.org powers our automated voice calls to families for antenatal and infant care checkups

Going the extra mile, for the last mile