Thefollowing section provides an overview of the few mHealth initiatives carriedout in India to provide information, create awareness and bring out behavioralchanges in women. According to the latest government data, India’s infantmortality rate (IMR) declined from 37 per 1000 live births in 2015 to 34 per1000 live births in 2016. Mobiletechnology can be attributed to the decline in this number which contributed tothe reduction in delay in accessing maternal health. mHealth helps in improvingaccess, coverage and addressing gaps in delivery. However, it has been observedthat using mobile camera photos for diagnosis led to a reduction in theaccuracy of diagnosis.
Several studies have shown the effectiveness of mHealthtechnologies in advancing maternal and child health care in low and middleincome countries (Tamrat et al., 2012; Noordam et al., 2011 ; Sondaal et al.,2016). Yet, there is still a long way to go to meet the 2019 target of IMR 28per 1000 live births (Kaul, 2017). In 2012, apublic health program to improve maternal and newborn health was initiated inBihar by Care India with the support of Bill and Melinda Gates Foundation withthe overall goal of achieving the Millennium Development Goals (MDG) 4 and 5.
As an innovation in this program, the Continuum of Care Services (CCS) -(Maternal and Child) was introduced using an mHealth platform. Out of total3000, 500frontime workers including Accredited Social Health Activists,Anganwadi Workers, Auxilliary Nurse Midwives and Lady Health Supervisors weretrained to use the mHealth platform. The service delivery components namelyearly registration of pregnant women, three antenatal visits, tetanus toxoidimmunization of the mother, iron and folic acid tablet supply, institutionaldelivery, postnatal home visits and early initiation of breastfeeding were usedas indicators for good quality services. The resultant coverage of theseservices in the implementation area was compared with rest of Bihar andprevious year statistics of the same area and it was observed that thisintervention helped in strengthening the coverage, quality, equity andefficiency of services (Ramkrishnan et al., 2016). The Sisu Samrakshak (SSK)program in Andhra Pradesh, India, which was funded by the UNICEF, has been runningsince 2000.
It demonstrates the incorporation of data management into primaryhealth care services using mobile technology. Handheld devices are used by the”Anganwadi” workers to monitor the health development in the catchment area andcommunicate the data to the nearest rural health centers. Subsequently, thesame mobile device disseminates necessary information related to topics such aspregnancy, nutrition, and immunizations (Rao, 2009). Yet in another initiativeby UNICEF’s MAPEDIR (Maternal and Perinatal Death Inquiry and Response) aimedto tackle the maternal mortality at the family, community, health service, andpolicy-making levels. Emergency medical support in Madhya Pradesh was providedwith the help of 24 hour obstetric help line support to community members andhealth workers which helped in reducing delays associated with when to seekmedical care, identifying healthcare facilities for appropriate service andcare delivery.
mHealth initiatives have been used to collect data onimmunization and prenatal care visits in Haryana, with the help of handheldcomputers (Mechael, 2009).In another initiative in Andhra Pradesh, a provisionof handheld computers aided to collect and monitor nutrition, maternal andchild health activities.