By Idhries Ahmad
VIJAYAWADA, India, 08 April 2016- For more than two decades now 45-year-old Padmavati has been visiting pregnant women, mothers and new born children in her village in the Vijayawada district of the southern Indian state of Andhra Pradesh. Padmavati is one among 293,000 Auxiliary Nurse Midwives (ANMs), village-level female health workers in India, who are the first contact persons between the community and the health services in India.
An ANM caters to a population of 3,000-5,000 and her work primarily involves providing primary health services around maternal and child health, family planning, nutrition and immunisation programmes. Collecting health care data is an extremely important part of their job and an ANM captures around 200 key indicators related to health, nutrition and immunisation of pregnant women, mothers and new born children in their hard-bound paper registers.
An ANM like Padmavati handles more than one village, and on an average, carries 12-15 separate registers to record key data indicators to provide information to her supervisors while on the go. “We have to carry many registers while working in the field and we end up doing double the work that is required once—the entry in registers and then finally, entry in the central server,” says Padmavati.
“The work of manually copying the data from one register to another also takes up a lot of time. The amount of time I spend in maintaining these registries could be used more judiciously,” she adds, bringing to light some of the challenges of her work.
Moreover, the manual updating of the data, carries a risk of being data entered incorrectly and getting corrupted.
ANMOL – Making ANMs Online
Taking into account the issues faced by ANMs and to improve the overall standards of child and maternal health service provision in India and related data collection, the ministry of health and family welfare, government of India, with support from UNICEF, has introduced an android based tablet based application ANMOL.
ANMOL or ANM Online is a solution that aims to bring better healthcare services and better consultation to millions of pregnant women, mothers and newborns in India. ANMOL ends drudgery for ANMs by making their work paperless. The tablet allows them to enter and update the service records of beneficiaries on real time basis, which ensures prompt entry and updating of data. Since it is a completely digitalized process, the high quality of the data and accountability is maintained.
The tablet complements as well the ANMs’ tasks as counselors, by providing them with readily available information about newborns, pregnant women and mothers in their area. Furthermore, the list of an ANM’s pending tasks gets auto-generated.
Apart from these facilities, women and couples can be counselled using audio and videos on ANMOL tablets on subjects like high risk pregnancy, immunisation and family planning. All the data that ANMs put into the tablet, gets updated automatically in the central server. To tackle the internet outages, the tablet works in off-line mode and as soon as the internet connectivity is available, the data gets downloaded to the central server.
“ANMOL is aimed at improving the quality, effectiveness and timeliness of the delivery of quality services, specifically to rural populations, to ensure better healthcare for women and children,” says Dr Srihari Dutta Health Specialist with UNICEF India.
“The application aims at bringing awareness to the remotest populations, underserved communities and urban slums and through images and videos, and educating them about initiatives on health, maintenance of good hygiene, basic health care and precautions,” adds Dr Srihari Dutta Health Specialist with UNICEF India.
Digital India- A Reality
Sujatha works as an ANM in the Bodapadu Sub-centre in district Vijayawada of Andhra Pradesh. She is one amongst the many ANMs who took part in ANMOL Tablet’s pilot program, introduced by the government of India in Andhra Pradesh. Sujatha, like other ANMs, was quite apprehensive about learning the functions of the ANMOL tab and was unsure whether she would be able to operate it properly.
After attending the training sessions conducted by the Indian government and the UNICEF technical support team, Sujatha finds it much easier to use the tablet to key in her data as compared to doing the same in the registers.
“The ANMOL tablet is like my akka (elder sister in Telugu), a constant guiding support that helps me overcome my day-to-day issues,” Sujatha says. “It saves me a lot of time. My job has become very easy since I started using it. Now I can solve all my problems myself. I use ANMOL to make better connections with the people in the village and understand their problems better by talking to them,” she adds.
Sujatha has gained new confidence as she goes around the village, counselling women and couples using videos and audio facilities of the tab.
On World Health Day this year, the Minister for Health and Family Welfare in India, Mr Jagat Pratap Nadda launched the ANMOL application in front of a huge audience.
"ANMOL will be a revolutionary application that will give a significant boost to improve health services in India," J. P. Nadda said. "The ANMOL application will help implement health programmes successfully at the grassroots level,” the minister added.
The government of India plans to roll out ANMOL to all the 293,000 ANMs in a phased manner.