After enjoying a Â scrumptious and of course nutritious lunch, our participants broke off into smaller working groups to innovate and ideate around maternal and child healthcare delivery in India. The purpose was to look at all elements within this system- evolution of theÂ medical ecosystem, government involvement and accountability, civic action towards healthcare – and identifying innovations around a systemic revamp that is maternal-centric. Each Innovation Group will now present their suggestions to a panel of healthcare experts and receive feedback on their ideas. The aim is to have ideas that are actionable, measurable and scalable for a revolution in the maternal and child healthcare delivery system in India.
Stella Luk, Â Shireen Miller, Aditya Dev Sood, Girindere Beeharry and Sheena Chhabra formed the panel that offered input on individual working groups.
Summaries of the Working Groups
A collaborative session by BIL and PATHLabs, Divya Datta took the lead on presenting the groups’ findings. Tackling the issue of blanket medical care provided to mothers which doesn’t cater to specific problems or deficiencies she could be facing. An integrated maternal health vitals diagnostics- BP pulse, temperature and abdominal circumference- a prototype, has been proposed by the group. The basic maternal health vitals can be recorded through this device by an ASHA worker. This device connects to an app and presents the patient’s details in a simple, easy to read format. Doctors will be able to keep tabs on a patients progress, health etc. This data can be aggregated at the PHCs-taking stock of healthy mothers, mothers in need of specific care and the like.
The app gives a suggestive care plan, a nutrition plan, what kind of need based subsidy can avail room the government and the followup that needs to be made by the ASHA. This will also generate a birth preparedness plan for mothers to be aware of what they need to watch out for after the delivery. Several components added in the working group, one of the key additions is an IVRS system linked to this platform as well.
The policy and advocacy suggestions that Lysander Menezes made were to create standards of the government product design, NHRC be a part of this process, advocate to the government, on their approval, move into organizations in this space like the Grameen Foundation to create awareness about the product.
The solutions proposed to create a mother and child centric ecosystem focussed on Nutrition. Communications was central to the success of this- making mothers aware of facilities, pre-natal care, services provided by ANC’s, ASHA’s and PHCs. The ANC should establish the link between a mother’s nutrition and her child’s health, provide a dietary plan. Second visit should do a check in and make alternations based on vitals and so on and so forth with every visit- detailing the benefits of breastfeeding.Â , Third Â and fourth visit should prepare the mother for her birth, discuss the benefits of breastfeeding and the fifth visit should reiterate all the messages provided so far. The communications channels are instrumental in this process- mass media for maximum outreach is the way to go.
Some of the innovations would be to demonstrate how to prepare nutritious foods for children and educate both the mothers-in-law and mothers about the same. The nutrition farm should be moved indoors and provide potted plants that can be watered at home. So at the time of the ANC visit, plants are provided which serve as a direct and nutritious dietary Â supplement.
The feedback from the panel was mainly cautionary but also encouraging. TheyÂ was appreciative of BILs understanding of the complex nature of the system and that ASHA workers would be motivated by far more than money. The key notes can be summarized as follows
- Be cognizant of the regulatory environment surrounding the deliver system
- Merging technology and innovation with healthcare should be beneficial to all parties- ASHA, patients and the village community.
- Build systems that are able to complement and support all holistically.
- Remote areas and marginalized groups- how easy is it for them to operate this? Is there a way to assimilate all this information AND guarantee no loss or misuse of information?
- BMGF recently entered the m-health and e-health space. The market is ripe since there is no tech health assessment agency to rationalize options. So whoever manages to get into the market first will have a potential donor and partner.
- The second WG would need to look at more innovations since their findings were largely already known
- Kudos to the grievance redressal system which came out as a great innovation
- Mobilizing and empowering the ASHA community into community health leaders is paramount, although facilitation will also be crucial