Technology and knowledge are key to delivering rural healthcare

28-Jan-2016 #Digital India Source: India Inc

by Nitin Dahad

Digital India is truly about improving lives. Tech leader Nitin Dahad lays out how connected technology is empowering communities to lead healthier lives in rural and remote parts of India through public-private & community partnerships.

Recently, while attending a meeting of the UK friends of JSS Bilaspur, a non-profit organisation that is concerned with improving public health in rural central India, I wondered about the role and extent of progress of technology in rural health in India. Is all the talk of increased mobile connectivity, Digital India and internet of things, making any real impact on rural India? Is this whole burgeoning app economy doing anything that is of value other than improve social media, retail and consumer experiences?

While the JSS may not yet be able to experience the full impact of technology, the organisation could, with the right support from supporters and volunteers, receive both the technology and skills to increase its reach and capabilities for local villages in central India. It started as a community health programme in a cluster of eight villages, and is now running its programme in 70 tribal villages in four clusters in the Kota and Lormi blocks of Bilaspur district. These villages are located in forests or at the forest-fringe, and many of them lack access to all weather roads.

From a tech point of view, more than the roads, the area is likely to benefit from technology if telecoms and broadband infrastructure is also improved. This was in fact a key topic at last week’s Convergence India conference in Delhi. Ministers and industry agreed there is a need for more innovation to meet the goals of Digital India.

In one of the keynote addresses by Ajit Balakrishnan, founder & CEO of Rediff.com, he said that broadband is more critical a national infrastructure than roads and bridges for creating jobs for young people and generating GDP growth. In particular, the attendees deliberated on affordable broadband for rural India, and facilitating Prime Minister Narendra Modi’s vision of making India a ‘digitally empowered’ economy.

Coincidentally, the Government of India also recently launched a mobile health program designed by BBC Media Action, to train one million community health workers and help nearly 10 million new and expecting mothers make healthier choices and lead longer, healthier lives. Its ‘Mobile Academy’ is designed to refresh community health workers’ knowledge of simple steps families can take to improve the health of mothers and babies, as well as improve their ability to communicate these steps clearly to mothers and their families.

BBC Media Action India’s ‘Kilkari’ platform delivers free weekly audio messages about pregnancy, child birth, and child care directly to families’ mobile phones from the second trimester of pregnancy until the child is one year old. Kilkari complements the Mobile Academy service by reinforcing health workers’ counselling of families, and communicating directly with new and expecting mothers and their families to increase the uptake of healthier behaviour.

Kilkari is now making calls to 850,000 families in six states, and will be expanded to reach 9.5 million new and expecting mothers per year. Mobile Academy is now accessible to 150,000 health workers across four states, and will expand its reach to one million health workers.

These services are designed and developed by BBC Media Action in the state of Bihar with support from the Bill & Melinda Gates Foundation, and powered by the open source mobile health technology Motech, developed by the Grameen Foundation for both inbound as well as outbound services, and integrated with software from IMImobile. The m-health services are now being rolled out nationally by the Ministry of Health and Family Welfare, with funding from the Government of India, the Gates Foundation, USAID and the Barr Foundation.

Rahul Mullick, head of ICT & supply chain at the Bill and Melinda Gates Foundation, said about the project: “The national launch of mHealth services is a great step towards leveraging India’s increasing mobile penetration to make healthcare services accessible to everyone across India. We at the foundation believe technology can offer compelling solutions in solving public health challenges and are committed to supporting the government in its ambitious agenda of prioritising equitable access to public health services.”

Sara Chamberlain, digital director, BBC Media Action India, added: “The Ministry of Health and Family Welfare’s commitment to using mobile phone technology to provide free reproductive, maternal, neo-natal and child health education to every new and expecting mother in India is a ground breaking step towards realizing the vision of Digital India. We are proud to be a part of this transformational initiative.”

These vital services improve front line health communication in areas where mobile communication is the only viable option for providing much needed health advice. Jay Patel, CEO of IMImobile, one of the technology providers for this service, commented “This key initiative highlights how the use of mobile engagement technologies can make a huge difference to people’s lives. There are over one billion mobile users in India and we hope to play a crucial role in assisting organisations that need scalable multi-channel technologies in order to realise the vision of a Digital India.”

The Motech open source solution is used in a number of additional healthcare projects in India, including one to support tuberculosis patients in Bihar, by World Health Partners. Motech provides the foundation of an integrated patient management system to facilitate suspect tracking, to support treatment adherence through tracking, reminders and alerts, and to generate reports enabling timely, quality access to tuberculosis diagnosis and treatment to Bihar’s rural population.

The software integrates with WHP’s existing electronic medical record, ReMeDi, built by Neurosynaptic Communications – the latter, being a comprehensive e-health solution for screening, primary diagnosis and triaging that connects the entire healthcare ecosystem: mobile health workers, telemedicine centres, diagnostic labs, doctors and hospitals. The system can operate on internet, intranet, wi-fi or a data card.

Interactive voice response (IVR) calls are made to HIV-positive patients reminding them of appointment and pill times. Patients can report their adherence with pill regimens or indicate they aren’t able to take their medicine. Patients with side effect symptoms can get feedback on what to do about them so they can continue their treatment. Nurses have a web-based tool which allows them to view patient adherence data and input/view patient medical data.

As illustrated by the various projects highlighted in this article, technology solutions can enable education and awareness to maintain good health, and to empower health workers to deliver the healthcare that rural areas and villages may not currently have. Which brings me back to the JSS Bilaspur meeting: the key takeaway was that while equipment and technology fit for rural tribal areas are needed, there is also a need for knowledge and training from medical or clinically trained experts. Technology and healthcare knowledge are needed together to enable effective rural healthcare, not just technology alone.

nitin_dahad_130x140Nitin Dahad is a consultant and advisor to the technology, industrial and media sector, and to government agencies and trade organisations, to develop global market strategies and programs based on nearly 30 years’ experience across Europe, US, Asia and Latin America

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