Catholic Relief Service


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Catholic Relief Service's Remind Project: Using technology for mother and child survival.

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  • (1 – 1.5 minutes for this slide.)NOTES: Use the slide title, ‘Why Mother & Child Survival’ as a way to catch the audience’s attention. Ask them (don’t wait for a response) why mother and child survival matters? Why, when there are so many other issues we could focus on—climate change, livelihoods and economic develop—that CRS is choosing to focus on mother and child survival in India.THEN, advance the slide (have added animation) so that the stats show. You don’t have to expand on the statistics that much—but be sure to share them slowly and clearly with a bit of a pause between each one to give time for the numbers to sink in…Showing the figures this way will be easier for the journalists to understand. If anyone asks about source of the child data, it’s:The Situation of Children in India: A Profile. New Delhi: UNICEF (May 2011). The maternal data is from Trends in Maternal Mortality (1990 – 2010) WHO (2012)
  • (1.5 – 2 minutes for this slide)These numbers help to focus in on the maternal and child survival situation in UP. As with the previous slide, use the title (‘Why Uttar Pradesh’) to get the audience’s attention before launching into the statistics. “Why has CRS chosen to work in Uttar Pradesh….?”If anyone asks where the ‘1 out of 35 people’ statistics comes from, just ask them to multiply 200,000,000 (UP’s population) time 35 and see what they get: 7 billion (the planet’s population).Be sure to say “Millennium Development Goals” as you talk through the slides before reverting to the ‘MDG’ acronymAfter you go through the statistics (the first 4 major bullets), advance the slide one more click. You’ll get the last line “Make a difference in UP, and you make a difference in the world!” Use this as a wrap-up line to bring together the points about the size of UP and it’s poor rates of maternal and child survival driving global progress toward MDG achievement. MDG 4 – child mortality – reduce it to 42 per thousand live births by 2015. MDG5 – maternal mortality is reduced to 109 deaths per 100,000 live births
  • (1 – 1.5 minutes)These statistics are from UNICEF: slide only shows the leading causes of maternal death. Could be noted (verbally) that more than half of all married women are anaemic and one-third of them are malnourished. This increases the risk of complications (including hemmorhage) and increases the risk of low birth weight—a leading cause of newborn death—and child malnutrition. ‘Adequate maternal care before and after birth’ includes antenatal care (TT, IFA, etc.), postpartum visits, adequate nutrition and rest before and after pregnancyAfter reviewing the maternal states, say
  • (1.5 – 2 minutes)Data source: (UNICEF) review major causes of child deaths—emphasize the deaths during the newborn period (first 28 days of life) account for almost a third of all child deaths. And of newborn death, the vast majority happen in the first 24 – 72 hours after birth. KEY MESSAGE: To improve in child survival, newborn deaths have to be addressed.
  • (< 1 minute for this slide)Briefly go through this overview of the project—emphasize CRS more than the project. (Spend less than a minute on this slide)You can explain that a ‘block’ in India is roughly the size of a “county” in the U.S. You can even say that Manjhanpur Block—where the project first started—has a population of 182,000
  • (up to 2 minutes for this slide)The idea here is a hook to get the audience’s attention before going into why CRS has opted for a technology solution. Spend not more than 2 minutes on this slide. But take the time to ‘paint a picture’ of what the ASHA’s work/life is like.At any one time, the ASHA could be supporting 1,000 pregnant women and 98 children under-5…
  • Say ‘application’ instead of ‘app’ when you first introduce this slide, but then it’s fine to just say ‘app’
  • Catholic Relief Service

    1. 1. REMIND PROJECTUSING TECHNOLOGY FOR MOTHER & CHILD SURVIVAL International Reporting Project Presentation 19 February 2013 – Mumbai, India
    2. 2. Why Mother & ChildSurvival? 1 out of every 5 children less than 5-years old on the planet lives in India. (20% of the world’s children) 1 of every 4 childrenwho dies, dies in India. (25% of all child deaths worldwide) More than 1 out of every 5 women who die during pregnancy, delivery or soon after, dies in India (19% of all maternal deaths worldwide)
    3. 3. Why Uttar Pradesh? •India’s most populous state • 200,000,000 people •Almost equal to population of Brazil •1 out of every 35 people on the planet lives in Uttar Pradesh • UP has some of India’s worst statistics in terms of mother and child survival • Mother and child deaths in UPthreaten both national and global achievement of MDGs 4 (reduce child mortality) and 5 (improve maternal health)Make a difference in UP, and you make a difference in the
    4. 4. Causes of Maternal Deaths in India Hemorrhage (38%) Infection (11%) Most mother’s deaths are preventable through safe delivery and adequate maternal care before and after birth
    5. 5. Causes of Child Deaths in India Newborn causes (33%)  Prematurity and low birth weight, birth asphyxia, infection Respiratory Infection (22%) Diarrhea (14%) Malnutrition contributes to one-third of child deaths ―By taking women into account, child survival can be influenced where it begins — in the years, months, and days before a child is born and in the critical
    6. 6. Project Overview Reducing Maternal and Newborn Deaths (ReMiND) Project Partners: Vatsalya, Dimagi Inc. Area of Intervention:  2 blocks of Kaushambi District, Uttar Pradesh Beneficiaries:  45,762 Project Duration: 3 Years (Oct 2011 – Sept 2014) Donors: CRS, USAID DIV 2.0
    7. 7. Imagine that you are an Accredited SocialHealthActivist…  Female community health worker covering a rural population of about 1,000  Estimated 32 pregnant women & 98 children under-5  Mostly Low literate and some are functionally illiterate  Communities’ first point of contact with the health system  Volunteer with financial incentives  Have about 28 days of training and limited supervision
    8. 8. Mobile ApplicationCustomized app usingCommCare software: Useful details about clients retained on phone for easier case management Culturally-appropriate images for counseling and to aid low-literate users Locally-recorded audio messages for clients as well as ASHAs All text and interface in Hindi
    9. 9. How ReMiND pregnancy applicationworks? Pregnancy Checklist • Counsels on • Filled as soon Form Outcome as ASHA learns • Antenatal check up form of pregnancy - starts I trimester • Home Care -starts I • Collects: ID • Filled at least once trimester each trimester • Filled after details, Last • IFA - starts II delivery or Menstrual trimester end of • Collects: Period, • Danger Sign starts II pregnancy Registration with previous trimester Auxiliary Nurse pregnancies, • Collects Midwife, services • Institutional live children, birth availed (Ante Natal delivery - starts III • Tells Estimated check up, Tetanus trimester outcome Date of vaccination), Current • Five cleans - starts Delivery practices (Iron Folic III trimester Acid, work/rest, nutrition, birth • New born - - starts preparation) in 9th month of Registration pregnancy Form Counseling Forms
    10. 10. Why Use Technology? ASHA case management app:  Helps in comprehensive counseling with standardized messages  Supports timely and appropriate counseling  Supports identification and referral of women & newborns with danger signs  Tracks each woman’s knowledge, practices and services received  Tracks frequency and coverage of the clients by
    11. 11. Why use technology?Cloud Infrastructure Real-time monitoring as data is uploaded from the field Custom exports for data analysis and reporting
    12. 12. Challenges Appropriate time and staffing must be available in the start-up phase to ensure quality content and initial roll-out of CommCare to ASHAs. Initial learning curve of ASHAs who have little or no previous experience using mobile phones Working with ASHAs who have no functional literacy Engaging middle level supervisors of ASHAs to support them Frequent change in the leadership in government at district level
    13. 13. Pleasant Surprises ASHAs report multi-media app helps give them more credibility with clients—validates key health messages Coverage of mobile network agencies is available even in very remote areas. Despite electricity supply issues, ASHAs have found back-up mechanisms to keep their phones charged. Support is being provided by the family members of ASHAs who are functional illiterate. District project team is able to resolve almost all
    14. 14. Questions