GHA Delhi Team End of Summer Presentation

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  • 1. Designing an M&E System For Maternal Health in Jasola GRC/JMC/NC/DU Summer 2012, Jasola, Delhi, I ndia
  • 2. DESIGNING TARGETED HEALTH INTERVENTIONS Global Health Affairs Program, University of Denver
  • 3. UNDERSTANDING THE •Who?PIECES OF THE HEALTH •What? •When? PUZZLE •Where? •Why? •How?
  • 4. Who: GRC JMC NC
  • 5. ANTENATAL CLINICS AT THE GRCFrom July 2011 to April 2012, 60 women have visited the GRC for the ANC clinics Basic Demographics Age: 17 - 40 years (average 26) Weight: 28 – 70 Kg (48 Kg) Age at marriage: 16 – 26 (18) Age when had 1st child: 16 – 24 (19) Number of births: 0 – 8 (3) Where and How
  • 6. KNOWN HEALTH ISSUES Pregnancy and delivery:  Multiparity  Lack of spacing between births  Anemia  Urinary infections Other Issues:  Nutritious food during pregnancy and after childbirth  Appropiate rest after childbirth  Almost all of them complain about back and body painWhat and Why?
  • 7. ENGAGING THE COMMUNITY Focus groups With Mothers on Maternal and Child Health (MCH) Knowledge of health issues Perception of available health services Ideal scenarios for improved health:  Services  Education  Technology
  • 8. MOTHERS KNOW BEST FOCUS GROUP RESULTS1. Knowledge of health issues • Symptoms: mild vs. severe conditions • Ailments and treatment • Seeking health attention 2. Perception of available health services  Public vs. Private  GRC and AWWs3. Ideal scenarios for improved health • Affordability • Proximity • Improved attention
  • 9. - Dizziness Symptoms - Weakness Baby cries Mild - Very sleepy Severe a lot Dry lips and throat, doesn’t drink milk, Lack of dehydration, more - Tough for appetite vomiting, silent child to survive Stomach Thin - Weakness swells, - Doesn’t stomach play ache anymore - Pale and yellowish More frequent skin defecation, +10 times a day Black and green poop that scatters to legs, 2-4 times a dayPerceived Health Issues
  • 10. CONVERSATIONS WITH GRC STAFFKey Topics Challenges to current work Lessons learned from MCH Focus Groups Ideal Scenarios for improved institutional capacityFollow-up Steps Taken Trainings on leading Focus Groups and facilitated dialogue Next Steps for improved institutional capacity  Foster relationships with AWWs  Increased and improved health analysis  Subsequent advocacy on a variety of health issues  Designed and tested pilot technology solutions
  • 11. PILOT TESTINGTECHNOLOGY SOLUTIONS
  • 12. CURRENT DATA MANAGEMENT SYSTEMSLargely Paper-based Integrated with excel spreadsheets, but often saved on different computers.
  • 13. DATA MANAGEMENT PROBLEMS KEY THEMESGRC Location issues: finding and following up with Mothers and Children Difficulties in tracking mothers over time Greater demand for services than GRC can supplyJMC/NC Desire for long-term analysis of key health issues Difficulty in sharing information between organizations (JMC, GRC, NC, DU).
  • 14. CONSIDERING TECHNOLOGY SOLUTIONS My wish Reality
  • 15. Ideal ScenarioJMC, GRC, and NC will be able to track all pregnant and young mothers in Jasola by location and overtime, and be able to share all information with each other with ease.
  • 16. A world of technology ?
  • 17. PROS AND CONS OF MOBILE PHONESPros: Relatively cheap to use Many people have them SMS can be integrated into database systems Creates a two way communication flowCons: Fewer women use them than men in Jasola Often only one per family Low literacy rates make it difficult to use SMS, as opposed to a voice-based system
  • 18. ANOTHER LOOK AT DATA MANAGEMENT PROBLEMSGRC Location issues: finding and following up with Mothers and Children Difficulties in tracking mothers over timeJMC/NC Desire for long-term analysis of key health issues Difficulty in sharing information between organizations (JMC, GRC, NC, DU).
  • 19. ANOTHER LOOK AT DATA MANAGEMENT PROBLEMSGRC Location issues: finding and following up with Mothers and Children Difficulties in tracking mothers over timeJMC/NC Desire for long-term analysis of key health issues Difficulty in sharing information between organizations (JMC, GRC, NC, DU).
  • 20. Lets talk about maps….Again…..
  • 21. USING MAPS TO:Resolve location issues by Geographically tracking mothers Analyzing their health problems over time In a way that can be shared between all groups
  • 22. SAMPLE MATERNAL HEALTH INDICATORS Minimum 3 ANC Initiation of Safe breast- Pregnancy delivery feeding and 28 days post delivery Post Immuni- natal zation checkups
  • 23. MAPPING: FIRST STEPSMultiple mapping platforms examinedRegion was mapped, and combined with trainings for GRC and NC staff
  • 24. THE ADVANTAGE OF COMMUNITY BASED MAPPING Our Map Googlemaps
  • 25. Lets talk about layers
  • 26. WHAT ARE LAYERS?
  • 27. WHAT ARE LAYERS?
  • 28. OUR LAYERS Level 1 - Base Layers  Roads  Water  Schools  Temples & Mosques Level 2 - Interactive Layers  Clinics  Anganwadi Workers  Pharmacies  Mothers
  • 29. BASE LAYERS
  • 30. INTERACTIVE LAYERS
  • 31. Platform uses entirely free and open source systems 1. Data shared and stored on googledocsand googledrive2. Base layer edited on Open StreetMap 3. Interactive layers edited and accessed on Geocommons
  • 32. FLOW CHART OF INFORMATION ANC Clinic Indicators on Indicators on at GRC printed Googledocs forms Indicators on mapAdvocacy Referral Analysis
  • 33. Questions and General Discussion