Table 1

Case study overview

Case study (inception year)Components/functionsActorsCoverage
Mobile Academy for India’s Accredited Social Health Activist (ASHA) community health workers*
(piloted from 2012, scaled in 2016)
  1. Phone-in interactive voice response (IVR) mobile refresher training designed to improve FLHWs interpersonal communication skills on preventative reproductive, maternal, newborn and child health (RMNCH) behaviours.

    • 44 short (~2.5 minute) pre-recorded audio lessons; total course length 240 minutes.

    • 44 yes/no, multiple choice quiz questions.

  2. MOTECH system which is interoperable with and ingests mobile phone numbers of ASHAs from Maternal and Child Tracking System (MCTS)/Reproductive Child Health (RCH; validation checks help to bolster MCTS/RCH data quality.

*Mobile Academy was designed to work together with two ‘sister’ programmes, also developed by BBC Media Action and initially implemented in Bihar.
  • Kilkari, a direct-to-FLHW health message programme which delivers prerecorded audio health information messages weekly to pregnant and postpartum women and has been scaled across 13 states nationally.

  • Mobile Kunji, an audiovisual job aid to help ASHAs communicate with community members. ASHAs use a deck of 40 colour-coded cards with illustrations, and access supporting audio by dialling into an IVR service. Mobile Kunji has not been scaled up beyond the state of Bihar, where it has been adopted by the Bihar State Health Society.

Technology development: Beehyv, Grameen Foundation, Dimagi
Technical development and implementation: BBC Media Action
Funders: BMGF, USAID, the Barr Foundation
Programme support and management: Government of India’s MoHFW; National Informatics Centre (NIC); Price Waterhouse Coopers
Telecommunications, IVR, hosting and data centre: Reliance Communications Limited, Railtel, IMI Mobile.
  • Implemented in 13 of 29 states.

  • Around 267 000 ASHAs, 43% of all ASHAs registered in the government’s databases, had started the course (as of March 2019).

  • 180 500 (30%) of all ASHAs registered, had completed it as of March 2019.

ANMOL for auxiliary nurse midwives (ANMs), India’s front-line subnursing cadre
(2017)
  1. Android-based tablet application for ANMs that supports data capture and service delivery planning for health and nutrition services to pregnant women, mothers and children <12 months.

    1. Preloaded audio and video files used to counsel women and couples on subjects like high-risk pregnancies, immunisation and family planning.

    2. The tablets maintain an auto-generated list of pending tasks.

  2. Interoperability with the RCH database—it feeds data captured by ANMs into the RCH database

  3. Comprehensive dashboards display reports on data captured.

Technology development: Dhanush Infotech
Technical development and implementation: Dhanush Infotech with other technology partners
Funders: Unicef and Ministry of Health and Family Welfare (MoHFW)
Programme support and management: Government of India’s MoHFW, NIC.
Implemented in 9 of 29 states
50 000 ANMs of 293 000 in India were using the tool as of early 2018
NCD App for ANMs
(piloted from 2018, scaled in 2021)
  1. A comprehensive primary healthcare platform (CPHP) that supports technical interoperability with the MoHFW’s MCTS, RCH and other electronic health information systems.

  2. An Android application on a tablet that sits on the CPHP and supports ANMs in conducting NCD screening and management for all adults over 30 years of age.

Technology and technical development: Dell EMC
Implementation: Tata Trusts
Funders: Dell EMC, Government of India
Programme support and management: Government of India’s MoHFW.
  • Implemented in 26 of 29 states

  • Almost 100 000 tablets in the field running the NCD app

  • Nearly 20 000 ANMs have logged in over the last 30 days (as of Oct 2019)

TECHO+ (Technology Enabled Community Health Operations) for ANMs and ASHAs
(piloted from 2013; scaled in 2017)
  1. Data capture, decision-support and scheduling android application for mobile phones used by ASHAs and ANMs to deliver to deliver health and nutrition services to pregnant women, mothers and children <12 months.

    1. Decision support in form of digital checklist to encourage adherence to protocols during home visits.

    2. Scheduling and activity planning in form of reminder to ANMs to plan for village health and nutrition day.

    3. Longitudinal, digital tracking of pregnant women and infants’ health status and services.

    4. NCDs, nutrition, developmental delays, communicable diseases, and mental health modules are being added to achieve comprehensive primary healthcare in alignment of Ayushman Bharat.

  2. Targeted client communication using multimedia to transmit targeted health information and improve counselling for behaviour change communication.

Technology development: Argusoft India Ltd., Gandhinagar
Implementation: SEWA Rural, Jhagadia
Funders: Government of Gujarat, UNICEF (research funding from Indian Council of Medical Research, WHO and MacArthur Foundation)
Programme support and management: GVK EMRI, Government of Gujarat
  • 90% of Gujarat’s population enrolled in TeCHO+ (as of Feb 2019)

  • 100% of all pregnant women and under five children enrolled

  • Gujarat Government health department and National Health Mission gave 11 000 smartphones and data plans to all ANMs in 2018

Common Application Software (CAS) for Anganwadi workers (AWWs), India’s community pre-school and nutrition supplementation workers
(2018)
  1. Data capture and decision-support android application for mobile phones used by AWW and their supervisors to deliver health and nutrition services to pregnant women, mothers and children <12 months.

  2. The CAS AWW app replaces 10 of the 11 paper-based registers AWWs used to maintain and consists of 8 modules: household management, home visit scheduler, daily nutrition, growth monitoring, take-home rations, due list, Anganwadi centre management and monthly progress report.

  3. The CAS supervisor app providers supervisors with a checklist which allows them to identify how the AWWs in 10–20 Anganwadi centres are performing, and provides data to inform discussions at monthly sector meetings.

  4. CAS web-enabled dashboard allows real-time monitoring by Integrated Child Development Services (ICDS) officials

  5. CAS is supported by the CommCare, an open access technology platform. CommCare is not interoperable with the MoHFW’s RCH or MCTS databases but creates its own database which serves as a data repository for the Ministry of Women and Child Development.

Technology development and implementation: Dimagi
Technical development and implementation: BMGF
Funding: BMGF, MoWCD
Implemented in 24 of 29 states.
~354 000 Anganwadi Centres using ICDS-CAS (as of June 2019).
  • FLHW, front-line health workers; MoWCD, Ministry of Women and Child Development; NCD, non-communicable diseases.