OVERVIEW OF REMIND
CONTENT & APPLICATION
STRENGTHENING ASHA HOME VISITS FOR
MATERNAL, NEWBORN AND CHILD SURVIVAL
UP-NRHM S...
PROJECT OVERVIEW
Reducing Maternal and Newborn Deaths
(ReMiND) Pilot Project
• Partners: CRS, Dimagi, Vatsalya
• Area of I...
COMMCARE –
REMIND’S TECHNOLOGY PLATFORM
CommCare as a Job Aid for ASHA:
- Track and support woman through
Pregnancy and Po...
SMS reminder
to ASHA
ASHA Registers
Pregnant
Woman
ASHA Conducts
Pregnancy
Home Visits
Delivery
DANGER
SIGN
DETECTED
Job A...
SMS reminder to ASHA and
missed visit alerts to supervisor
Postpartum Home
Visits for Mother –
Days
(0),3,7,14,21,28,42
En...
SMS reminder
to ASHA
Infant tracked
through Year 2
for Routine
Immunizations
Infant Case
Closed
Job Aid: assessment,
couns...
7
REMIND APPLICATION SUMMARY:
Five Modules to Guide the ASHA Workflow:
1. Registration of Pregnant Mothers
2. Management of ...
- Pregnancy Checklist
- Completion of ANC check-ups and Tetanus
Immunizations, Assess Use of Health Services,
Assess High ...
- Mother Postpartum Visit
- HBNBC Mother Form
- Postpartum Counseling
- Information about High Risks and Postpartum
Danger...
- Home-based Newborn Care Visit
- HBNBC Baby and CCSP forms
- Breastfeeding Assessment
- Additional follow-up for any moth...
SUMMARY
The ReMiND Pilot Project uses
CommCare to:
- Provide a Job Tool for the ASHA to
improve many aspects of her
work, ...
SUMMARY OF BENEFITS
Improved Work Quality:
- Checklists improve
performance
- Decision support
increase adherence to
proto...
14
THANKS
Assess Use of Health Services:
Early registration with ANM, TT
Vaccination, ANC 1/2/3/4
DANGER
SIGN
DETECTED
FORM EXAMPLES...
Visit Status Labels:
No. of days since delivery, no. of HBNBC
home visits conducted to date, whether
current visit on time...
Visit Status Labels:
No. of days since delivery, no. of HBNBC
home visits conducted to date, whether
current visit on time...
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ReMiND Pilot Project - overview of mobile application and content for ASHAs

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Catholic Relief Services partners with technology innovator Dimagi, Inc. and Vatsalya to implement the Reducing Maternal and Newborn Deaths (ReMiND) Pilot Project in 2 blocks of Kaushambi district in Uttar Pradesh (India). ReMiND works with government community health workers (called ASHAs) to improve the frequency and quality of pregnancy, postpartum and infant home visits. ASHAs use basic mobile phones operating Dimagi's open-source CommCare software, which equips them with multi-media job aids to support client assessment, counseling, and early identification, treatment and/or rapid referral of pregnancy, postpartum and newborn complications. This presentation details the content and workflow of the CommCare-based mobile application developed for and used by ASHAs through the ReMiND Pilot Project.

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  • ReMiND equips and trains ASHA on mobile-phone based tool to improve home visit counseling, assessment and referrals during the first 1,000 days of life (pregnancy, postpartum/newborn through first 2 years). ASHAs use basic feature phones (Nokia C2-01) operating Dimagi’s open-source CommCare software
  • ReMiND is promoting ASHA’s use of technology to support women, newborns and young children through the first 2 years of life. This slide summarizes how ReMiND’s CommCare application support’s ASHAs’ workflow from the time a pregnant woman is first identified up to the time of delivery.The pregnancy application is currently deployed with ASHAs in Manjhanpur and Mooratganj blocks.The SMS reminder portion of this workflow will be introduced later in 2013.
  • In the first 42 days of life, ReMiND has a mobile application that support home-based newborn care visits. The postpartum and newborn/infant applications are currently being field tested so that they can be introduced to ASHAs once Module 6 and 7 (or CCSP?) training is rolled out in Kaushambi District.
  • Beyond the first 42 days of life, ASHAs will use a “baby” application to track routine immunization through the first 2 years of life. This application will be rolled-out at the same time as the postpartum/newborn applications.
  • (Very brief—not more than 30 seconds on this slide)This diagram, available in your handouts, summarizes how the ReMiND mobile application supports ASHA’s home visits from pregnancy through the first 2 years of life.
  • Highlight the use of labels and color-coding (pregnancy = yellow, postpartum mother = green, baby = blue) to help low literate ASHAs more easily navigate the application.
  • WE CAN DISCUSS WHETHER IT WOULD BE GOOD TO INCLUDE REFERENCE TO THE LiST ESTIMATE OF THE NUMBER OF CHILDREN’S LIVES THAT CAN BE SAVED (OR ESTIMATED REDUCTION IN NMR/CMR) WITHIN 2 YEARS OF REMIND WERE SCALED TO ALL 8 BLOCKS OF KAUSHAMBI….
  • ReMiND Pilot Project - overview of mobile application and content for ASHAs

    1. 1. 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
    2. 2. 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 2
    3. 3. 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 3 CommCare as a Decision Support tool: - Helps the ASHA identify Danger Signs and make the appropriate referral
    4. 4. 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 4
    5. 5. 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 5 Newborn Home Visits for Baby – Days (0),3,7,14,21,28,42 Mother’s Case Closed Delivery
    6. 6. 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) 6 End of Post- Partum Period
    7. 7. 7
    8. 8. REMIND APPLICATION SUMMARY: Five Modules to Guide the ASHA Workflow: 1. Registration of Pregnant Mothers 2. Management of Pregnant Mothers 3. Management of Postpartum Mothers 4. Management of Newborns & Young Children 5. Referral Follow-Up 8
    9. 9. - 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: 9
    10. 10. - 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
    11. 11. - 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
    12. 12. SUMMARY The 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 12 - 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
    13. 13. 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 13
    14. 14. 14 THANKS
    15. 15. Assess Use of Health Services: Early registration with ANM, TT Vaccination, ANC 1/2/3/4 DANGER SIGN DETECTED FORM EXAMPLES: Pregnancy Checklist Form 15 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
    16. 16. 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) 16 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
    17. 17. 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) 17 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

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