Across rural India, many maternal and child health issues go unreported due to gaps in the manual public health system. In Rajasthan, 40 out of every 1,000 children do not survive past their first birthday. Devli walks kilometers with her underweight six-month old daughter to a health camp where the front-line worker does not have complete information on her health card. A new digital system called Khushi Baby uses chips in necklaces or cards to digitally store health information which is scanned and updated at camps without connectivity and sends automated messages to improve care. It aims to better track health across the continuum from household to primary center through connecting providers, beneficiaries, and officials.

3. Across rural India, the public health system has failed to improve core issues of primary care delivery,
especially for maternal and child health. In Rajasthan, our major geography, 40 out of every 1,000
children do not see their first birthday and 420,000 women have high risk pregnancies. Altogether, <50 %
of maternal and child death are unreported.

5. Devli, a mother of a six-month-old girl, walks kilometers, her child in hand, across rugged terrain and 100+
degree weather, to reach the health camp in her village. Along with her, she brings a paper health card
which she shares with the front-line health worker. Unfortunately, vital information on this health card has
not been recorded. And so the health worker does not realize that Devli’s daughter has not gained weight
in the last two months. Additionally she asks “was your child born before or after the last festival” in order
to guess which vaccination is due for today.

6. Currently, health is tracked on paper. Mothers carry paper record from pregnancy onwards. Health workers have a
diary with a list of their patients. But paper has its problems - it’s not searchable, never complete, and moreover
data is hardly actionable. Beyond paper, community engagement of mothers is also a challenge. Community health
workers known as ASHAs have to travel from hill to hill walking kilometers to recruit mothers to avail these life
saving services.
But we can do better. With Khushi Baby, instead of a paper health record, mothers and children receive a digital
necklace or card. This contains a Near Field Communication chip which can store data like a pen drive. They bring
this necklace to the camp and the health worker scans their necklace and verifies their biometric to update their
health record.
It happens without the need of connectivity. Later the health worker syncs the data and from our dashboard, health
officials can take action. Automated appointment reminders are sent to the phones of the mothers, and also,
whatsapp messages are sent to the phones of the frontline nurses, so that they follow-up with the highest risk
patients.

7. ● A continuum of care which connects the village household, sub-centre and primary health center. The platform
includes a state-wide digital health census (India’s 1st) to establish an accurate baseline denominator and tracks
family planning, antenatal care, delivery monitoring, postnatal care and immunization.
● A mobile application for all healthcare providers, which replaces paper-based tracking, automates timely reporting
of health outcomes and resource shortages, automates direct benefit transfers, and guides clinical decision-making.
The app is designed to keep health workers informed of their progress and catchment area health status, so that they
can take necessary action.
● A digital medical record for beneficiaries, in the form of a NFC health card (30 INR), which moves with the patient
● Instant, offline sharing of digital medical records, via the NFC health card, at the point of care
● GPS, NFC, and biometric accountability at all points of care. This confirms that 1) health camps were held and 2) the
beneficiary met the provider
● Dialect specific automated voice calls for community engagement aimed to improve beneficiary health awareness
● AI powered actionable analytics and dashboard for health officials for timely decision-making

9. ● GPS and time-stamps: to track whether the health worker attended the scheduled health camp at the
designated time
● Offline & Contactless Digital Medical History and Biometrics: to ensure offline informed care and
patient-provider interaction
● Clinical Decision-Making: real-time feedback to health workers to promote accurate decision-
making, data entry and counseling
● Financial Empowerment of CHW: village level community health workers are paid on an incentive
basis. Our mobile app allows them to plan their services in accordance with projected financial
earnings.
● Health worker Data Quality Score: Our extensive data sets enable us to build AI models to predict

10. health worker diligence and filter high quality data to predict adverse maternal and infant health outcomes
● Forthcoming: Integration with bluetooth enabled multimodal point-of-care diagnostics to automatically
capture vital parameters (blood pressure, haemoglobin, blood sugar, foetal heart rate, weight)

11. Data collected is processed to output a “dilgence score” for each health worker. We then weigh the inputs from the
health workers through this data quality layer before using them for predictions of health outcomes. Based off the
expected probability of adverse outcomes, beneficiaries are prioritized and shared back in the mobile application in
the form of a due-list. Meanwhile, automated voice calls in the local dialect are sent to beneficiaries and health
officials gain spatial information on where to deploy community-level interventions

16. 400K+ daily cases, 4K+ daily deaths
In the context of COVID-19, problems within the public health system (gaps in manual data collection and action
capacity, awareness, data and accountability) translate similarly - COVID-19 cases go unrecognized, high risk
patients do not receive timely referral care, and citizens are not vaccinated. Further, the public health crisis is
affecting delivery of other primary preventative services, which will now require innovation and attention.

19. We are currently working to expand the solution to include and integrate other primary health care verticals beyond
reproductive and child health, as per national guidelines, so that each health worker in the referral loop has a
single unified interface for tracking patients and reporting community health outcomes across verticals.
This also includes a decision support tool for the new cadre of health workers - Community Health Officers - who
serve at the interface between ANMs and Medical Officers.
Vertical programs include:
RMNCH + A: Reproductive Maternal and Neonatal Child Health + Adolescent
NCD: Non-Communicable Disease
TB: Tuberculosis
IDSP: Infectious Disease Surveillance Program

20. How we know our solutions will work / why we were chosen as a Nodal Technical Support Partner in Rajasthan:
● 2 year RCT showing improvement in health outcomes
● Partnership with State Department of Health
● Financial contribution from State and Central Ministry of Health
● 5+ years of co-design with health workers on the ground
● Team capable of taking platform to scale within government machinery