OVERVIEW OF REMIND CONTENT & APPLICATION
STRENGTHENING ASHA HOME VISITS FOR MATERNAL, NEWBORN AND CHILD SURVIVAL
UP-NRHM SITE VISIT TO REMIND
JULY 2013 – KAUSHAMBI DISTRICT
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PROJECT OVERVIEW
Reducing Maternal and Newborn Deaths (ReMiND) Pilot Project• Partners: CRS, Dimagi, Vatsalya
• Area of Intervention:
2 blocks of district Kaushambi District (Manjhanpur & Mooratganj)
• ASHAs covered: working with 255 by end May 2013
• Project Duration: 3 Years (Oct 2011 – Sept 2014)
• Donors: CRS’ Private Fund and USAID DIV 2.0 Fund
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COMMCARE – REMIND’S TECHNOLOGY PLATFORM
CommCare as a Job Aid for ASHA:
- Track and support woman through Pregnancy and Postpartum periods
- Track and support baby from birth through first 2 years of life
- Localized and designed for ASHA use
Combines audio and still images for counseling and assessment content based on ASHA Modules 2, 6 and 7
CommCare as a Reminder tool:- SMS reminders sent to ASHAs to remind of
upcoming visits and alert supervisor of missed visits
CommCare as a Decision Support tool:- Helps the ASHA identify Danger Signs and make the appropriate referral
SMS reminder to ASHA
ASHA Registers Pregnant Woman
ASHA Conducts Pregnancy Home Visits
Delivery
DANGER SIGN
DETECTED
Job Aid: assessment, counseling & data collection
Referral & Treatment in
Health Facility
PREGNANCY WORKFLOW
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SMS reminder to ASHA and missed visit alerts to supervisor
Postpartum Home Visits for Mother –
Days (0),3,7,14,21,28,42
End of Post-
Partum Period
DANGER SIGN
DETECTED
Job Aid: assessment, counseling & data collection
Home Treatment or Referral to
Facility
POSTPARTUM & NEWBORN WORKFLOW
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Newborn Home Visits for Baby –
Days (0),3,7,14,21,28,42
Mother’s Case Closed
Delivery
SMS reminder to ASHA
Infant tracked through Year 2
for Routine Immunizations
Infant Case Closed
Job Aid: assessment, counseling & data collection
YOUNG CHILD WORKFLOW (UP TO 2 YEARS OF AGE)
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End of Post-
Partum Period
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REMIND APPLICATION SUMMARY:
Five Modules to Guide the ASHA Workflow:1. Registration of Pregnant Mothers2. Management of Pregnant Mothers3. Management of Postpartum Mothers4. Management of Newborns & Young Children5. Referral Follow-Up
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- Pregnancy Checklist- Completion of ANC check-ups and Tetanus
Immunizations, Assess Use of Health Services, Assess High Risks Signs in Pregnancy
- Pregnancy Counseling- Information about High Risks and Pregnancy
Danger Signs, Antenatal Care, Nutrition, Rest and IFA, Pregnancy Danger Signs, Birth Planning and Preparedness, Essential Newborn Care
- Pregnancy Outcome- Delivery information, Pregnancy outcome,
Newborn and mother’s health after delivery
- Modify Pregnant Woman Info- Modify identification info for woman, and update
EDD/LMP information
PREGNANT MOTHERS:
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- Mother Postpartum Visit- HBNBC Mother Form
- Postpartum Counseling- Information about High Risks and Postpartum
Danger Signs
- High Risk Follow up*- Follow-up on high risks identified, Decision
support for assessing high risks
- Postpartum Review - Provides summary of information about status
and health of postpartum mother, high risks identified, and next scheduled home visit
- Close Postpartum- To be filled 42 days post delivery once
postpartum phase is complete
POSTPARTUM MOTHERS:
10*Note – currently undergoing field testing
- Home-based Newborn Care Visit- HBNBC Baby and CCSP forms
- Breastfeeding Assessment- Additional follow-up for any mother/newborn with
a suspected feeding problem.
- Routine Immunization Tracking through 2 years- BCG, OPV, DPT, Boosters, Polio, Measles, VitA
- Routine Immunization Counsel- Information about vaccines, benefits of
immunization, side effects, how/where to go
- Update Baby Info- Update any details about the newborn case
- Close Baby- To be filled to close the baby case after 2 years of
care and full immunization
YOUNG CHILD:
11*Note – currently under design
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SUMMARYThe ReMiND Pilot Project uses CommCare to:
- Provide a Job Tool for the ASHA to improve many aspects of her work, including:- counseling- timeliness of visits- tracking of mothers and children- identification of danger signs- following up with referrals
- Use the power of mobile phones to collect data on service utilization and key MNCH practices
- Collect data in Real Time that can be used by supervisors and project managers immediately
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SUMMARY OF BENEFITS
Improved Work Quality:
- Checklists improve performance
- Decision support increase adherence to protocols
- Validation and skip logic to improve quality of data
- Reminders to ASHAs of upcoming visits & referral follow-up
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THANKS
Assess Use of Health Services:Early registration with ANM, TT
Vaccination, ANC 1/2/3/4DANGER
SIGN DETECTED
FORM EXAMPLES: Pregnancy Checklist Form
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Immediate Referral
Assess Pregnancy Danger Signs
Assess Behaviors:IFA Consumption, increased nutrition,
proper rest, birth preparedness
Referral Follow-Up Form:ASHA provides update on client’s condition & referral status (complete/incomplete) 24 hours
after danger sign identified
SMS Reminder to
ASHA to Follow Up
Visit Status Labels:No. of days since delivery, no. of HBNBC home visits conducted to date, whether
current visit on time as per HBNBC schedule
FORM EXAMPLES: Postpartum Home Visit Form (HBNBC Mother Form)
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HBNBC Mother Assessment as per NRHM form
Home Management as per protocol
Referral Follow-Up Form:ASHA provides update on client’s condition & referral status (complete/incomplete) 24 hours
after danger sign identified
SMS Reminder to
ASHA to Follow Up
Immediate Referral as per Protocol
NEWBORN COMPLICATION
IDENTIFIED
SMS Reminder to
ASHA to Conduct Visit
SMS missed visit alert sent to ASHA supervisor if visit not completed on time
Visit Status Labels:No. of days since delivery, no. of HBNBC home visits conducted to date, whether
current visit on time as per HBNBC schedule
FORM EXAMPLES: Postpartum Home Visit Form (HBNBC Baby Form & CCSP Form)
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HBNBC form for baby
Home Management as per protocol
Referral Follow-Up Form:ASHA provides update on client’s condition & referral status (complete/incomplete) 24 hours
after danger sign identified
SMS Reminder to
ASHA to Follow Up
Immediate Referral as per Protocol
MATERNAL COMPLICATION
IDENTIFIED
SMS Reminder to
ASHA to Conduct Visit
SMS missed visit alert sent to ASHA supervisor if visit not completed on time
CCSP Form:If signs of infection or feeding problems
identified with HBNBC form