Mobile application A modal Initiative to ensure quality family
planning services in Doiwala block, Dehradun, Uttarakhand
Rural Development Institute, Himalayan Institute Hospital Trust
Dehradun, Uttarakhand
Dr RAJEEV BIJALWAN RDI-HIHT
Rural development Institute
The mission of the Trust is to develop integrated and cost- effective approaches to health care and development that address the local population, and which can serve as a model for the country as a whole, and for the underserved populationworldwide.
A combined approach in which traditional systems of health care complement modern medicine and advanced technology, is the prime focus of clinical care, medical education, and research at HIHT.
MISSION
Founder - Dr. Swami Rama
Out reach Initiatives in Health and Development
Health :• Reproductive and Child Health (RCH)• Adolescent health• School health• Primary health careWater and sanitation • Management of natural sources• Drinking water and sanitation services• Development irrigation canal Education ScholarshipLivelihood contract farming on aromatic plants
Presentation has……………
Objectives Principle guide line for application
Geographical Interventional area
Type of information and entry processes
Systematic approach Development of key and its digitalization
Comparative status of Quality indicators
Flow of new information system
Existing Information system Processes of implementation
Loopholes of existing Information system
Key benefits
Concept of Innovation Way forward
Objectives To establishment client based
information management system
To develop cost effective and people friendly application
To ensure that we can use any networks as well as basic handset of
mobile
To ensue using simple operational process so that any one can use it at
community level
To ensure data migration, analysis and storage facility
To ensure the automatic feed back system
Working Area of Doiwala Block, Dehradun, Uttarakhand, India
Uttarkashi
Tehri Garhwal
HaridwarGarhwal
Chamoli
Bageshwar
Pithoragarh
Almora
Nainital Champawat
Doiwala
block
1 CHC& 5 PHC
32,ANM
centers
165 ASHAs
181 village
s
193346
population
21894 household
32873 eligibl
e coupl
e
Systematic approach
Comparative status of Quality indicators fact sheet
Indicators India Uttarakhand DoiwalaOverall discontinuation rate (1 year)
25.1% 28% 31.1 %
Temporary methods (1 year)
44% 37% 42 %
Pill(1 year) 45% 45% 33%Condom (1 year) 49% 34% 51%Offered basket of choice or informed choice
37 10.3%
Received pre checkups
* * 75.8%
Information about side effect
29 7.9%
Received follow up * * 44.6%
Existing information flow
CHC PHC
Area Coordin
ator
ANM Centers ASHA Eligible
Couple
Weakness of existing information system
1. Information is coming from various sources at various levels.
2. Maximum possibility of duplication or repetition
3. Do not provide actual status at community level
4. Do not provide any information about non users
5. No integration between service information with social determents
6. Large amount of paper use and no use of information in feed back
Mobile Application for QFPS MIS
Concept of innovative Mobile application
• Concept of application is based on client• Ensure effective use of information in
program feedback, researches and studies• Develop a cost effective and early response
system• Ensure program progress at all level• Use information system for staff appraisal• Ensure simple technology
• Develop client based information system Under the client based information system we always get the information from the client
• This system help us to understand the reach of the program at community level and assessment of performance of providers
• It always works as a external monitoring system which is not under the control of providers
Principal guideline for application
• No network restriction • Ensure use of basic set of mobile• Development of Simplification or digitalization of
information• Create reminder system and full scope for extension• Create free SMS system for health education and
information • Develop effective tools on the basis research for
staff training and orientation
Basic Entry Information• Name/ S. N.• Age• No of children M/F• Family status – Nuclear/ joint• Social status- APL/BPL• Education/ wife and husband• Occupation / wife and husband• Village/ code• Name of ASHAs/ mobile number• Name of ANMs/ ANM centers /mobile number• Medical officers / PHCs/ mobile number
Description of key S N Contraceptive s
(UC)
Women condition(WC)
Services(S)
Health providers (HP)
Place of health provider (PHP)
Users status (US)
1 NSV Newly married Counseling ASHA Village Non-user
2 Tubecotomy Pregnant Basket choice AWW AWW centre Switch over
3 Condom Post delivery Pre-checkup ANM ANM centre New user
4 OCP Abortion Follow up Govt. Doctor PHC/CHC Drop out
5 Cu-T Infertility Complication Pvt. Doctor Pvt. Hospital
6 E-pill Others Medical store
7 Injection
8 Female condom
9 SDM
10 LAM
11 Others
SMS keyUpdate entry RN,VC,MC,FC,UC,CW,S,HP,PSP,US*Comment
RN150,VC0010,MC2,FC1,UC2,CW3,S4,HP1,PSP3,US1*Comment
New entry VC,CN,A,MC,FC,UC,CW,S,HP,PSP,US*Comment
VC0010,CNANITA,A29,MC2,FC1,UC2,CW3,S4,HP1,PSP3,US1*Comment
• CHC wise Report
• PHC wise Report
• ANM wise Report
• Village wise Report
• ASHA wise Report
• Client status
• Users wise of Contraceptive
• Condition Of Woman
• Providers and service centre
• Total users, non users, switch off and switch over
• Demand calculation at all level
• Total umber receive pre check ups, counseling, basket of choice and follow-up services
Client based information collection Mechanism
NE- RN, VC, CN, A, MC, FC, UC, CW, S, HP, PSP, US *Comment
UE- RN, VC, MC, FC, UC, CW, S, HP, PSP, US *Comment
The flow of Information Management
ASHA (ASHA will collect individual information at household level)
Central Information Registration System at Rural Development Institute-HIHT
House hold level
ASHA level
ANM level
PHC level
CHC level
The information will be send on a prescribed format by the mobile phone through a SMS to the Central Information Registration System Center
Central Information Registration System (Software)
Community Level (Eligible couple)
Central Information Registration System will also send the reports of eligible couples to the all the centers every month by e-mail or postal services
The Central Information Registration System will evolve various reports automatically
Feedback and Monitoring System (Recheck process and reminder SMS
Application Suite Architecture
Web Server
DB Serve
r Mail Server
Application
Admin Application Interface
SMPP
SMSC
MMSC
GSM Modem Stack
Family Planning at Village Level Report from …………………. To …………………
A Model Inititative to Ensure Quality Family Planning Services in Uttarakhand
Doiwala Block, Dehradun
CHC Name ANM Centre Name Village Name
Name of the ANM ASHA Name
PHC Name CHC Incharge
Reg. No. Eligible Couple Name Entry M/Y Age
No. of living children
Use of Contraceptive Condition of woman Services Result
M F
Permanent Temporary Natural
Newly married
Post delivery
Abortion InfertilityCounseli
ng
Basket of
choice
Information- side
effect
Pre-checkup
Follow up
Satisfied with
services
Non-users
Switch over
New user
Drop outTubecot
omyVasecto
myCondom OCP IUD E-pill Injection
F_condom
Safe period
Exclusive breast feeding
Withdrawal
method
Flow of existing information
CHC PHC
Area Coordin
ator
ANM Centers ASHA Eligible
Couple
Process of Implementation
• Conducted a research study on various aspects on mobile phone such as use of SMS and other facilities
• Development of software• Pre testing• Re – design• Demonstration• Development of training materials and its delivery
process• Implementation of application
Key features of mobile application
• Independent of the Specific Mobile Handset• Independent of the Telecom Operator• Keywords Simplicity: • Master Databases Management: • Integrated Auto Push, Pull, E-mail (or Voice if required• Validation of Input Information• Predictive Analysis Scalable Approach• Automated Quality Analytics Feedback System• Interactive Voice Response System (IVRS) Integration
Key benefits• Highly Scalable Multi User Solutions over Wired/Wireless/GSM/CDMA
Networks• Immediate Information Transfer • Highly Targeted and Accountable Medium • Time Efficiency (Reduces Time Lag)• Economical (Cost Effective)• High Retention Value• Reduction of Manpower / Man Hours• Accuracy of Information Flow• Automated and Acknowledged Information Transfer to Multiple Points• Bulk Communication on touch button• Handy & Automated Accurate Information
Impact on program
• Easily get any information at all levels• Use tracking system to see specific cases at
any levels• Develop accurate demand for contraceptives
and ensure actual need based distribution mechanism at each stage
• Provide effective clinic services for specific area
Impact of program
Description Baseline
(Sep 2008)Year Oct 08- Sep 09
Year Oct 09-Mar 10
Total Eligible Couple 848 (sample size) 28005 30282
Tubecotomy 18.8 33 32.4
Vasectomy 2.0 0.5 0.9
IUD 1.7 2.5 2.2
Condom 21.7 31.2 27.9
OCP 7.2 13.7 8.6
Injection 0.1 0.1 0.4
E-Pill * 0 0.1
CPR 51.5 67 72.5
Way forward…….
• Planning for scaling up and extension of software
• Documentation of learning's and sharing it at state as well as national levels
• Use of information to improve the supply system
• Wider role of mobile technology in health sector
Ensure multiple use of mobile in health program for multiple
purpose