1. ImTeCHO (Innovative mobile phone technology for community health operations)
A joint initiative of SEWA Rural and Department of Heath and Family Welfare

2. Summary
Goal: Reduce maternal and child deaths and malnutrition through mobile phone application for ASHA programme
Operational since May, 2013 in Bharuch and Valsad district
6,500 beneficiaries through 110 delivery centres already benefitted, 20,000 m-transactions
Improvement in coverage and quality of services
Propose implementation in Narmada district in 3 phase implementation starting from Sagbara from Oct-2014

3. Our vision: India…
Where every person has the information they need to keep themselves and their family healthy no matter who they are or where they live
2. Where every health worker has the tools she needs to provide consistent and excellent care
3. Where the health system supports continuity of care through better information, logistics and management
Ref: Dr. Marc Mitchell at “mHealth for maternal health” meeting at HSPH

4. About SEWA Rural Mission Principles
Activities: Hospital, Vocational training center, Women empowerment program, Eye care, Community Health and research
Community Health so far: PPP for PHC mgmt ( ), Safe motherhood and newborn survival project ( ), ImTeCHO (2011- present)
Publications

5. Objectives of ImTeCHO
ImTeCHO is a new mobile phone and web application for ASHAs, PHC staff and health officials for
Reduction in maternal deaths
Reduction in newborn and child deaths
Reduction in malnutrition
Timely identification and management of sickness
among hard to reach and tribal areas of the state.
Scope: ALL community based maternal, newborn and child health services to be provided free through ASHA and PHC staff (G2C and G2G)

6. Support/Value creation for all involved in ASHA program
ImTeCHO = I am support
Supports ASHAs towards better
Morbidity detection and management (HBNC, IMNCI)
Scheduling tasks
Health education (BCC)
Support PHC staff and higher level staff towards better
Providing support and motivation to ASHAs(incentives and supply management etc)
Supervision and HR management
Reporting & HMIS
Support/Value creation for all involved in ASHA program

7. ASHA home visit

8. Who are the beneficiaries?
Pregnant women
Newborn babies
Children
Community level Health workers (ASHAs, nurse, medical officer etc)
Block, district and state level health administrators

9. Problem statement
Insufficient support, supervision and motivation to ASHAs (eg. Training, skills, mentoring, incentives, supplies etc)*
Inadequate performance of ASHAs
Low coverage of proven interventions (eg: HBNC)
Unsatisfactory health outcomes
*Ref: (1) Columbia University. Improving the performance of Accredited Social Health Activists in India: Working papers series. Mumbai. 2011
(2) National Health Systems Resource Centre (NHSRC) and National Rural Health Mission (NRHM). ASHA: Which way forward...? New Delhi, 2011.
(3) ASHA update Jan 2013

10. ImTeCHO= I am support ImTeCHO
Better support, motivation, supervision to ASHAs, FHWs and PHC staff
Better performance
Increase in coverage of proven interventions
Better health MNCH outcomes
Ref:

11. Main menu and schedule for ASHA

12. Automatic diagnosis and treatment

13. Videos and mamata divas

14. Motivation of users Announcement of positive case studies
“Congratulatory message” for completing tasks
Linking incentives
Newsletter
Monthly performance feedback in mobile

15. Supervision and support made easy and effective (Medical officer)

16. ImTeCHO for higher officials

17. ImTeCHO: Conceptual framework
Better support, motivation, supervision to ASHAs and ASHA program
Better performance
Increase in coverage and quality of MNCH services
Improvement in maternal and child mortality and malnutrition
Ref:

18. Current implementation
Project started in May, 2013 in Bharuch and Valsad district (Population: 90,000)
110 ASHAs and PHC staff are successfully using ImTeCHO
6,500 pregnant women, newborn, children benefitted so far
20,000 m-transactions so far
Will cover Narmada district soon
Significant improvement in coverage and quality of health services
100% pregnant women and 95% children are enrolled

19. Few quotations from users and clients
A beneficiary mother: “ Now, we receive timely services at our doorsteps”, “I came to know about so many new information due to videos in mobile which will keep me and my child healthy”
Medical officer from a PHC: “timely information from field due to ImTeCHO now helps me to supervise my staff from my office”
An ASHA: “My prestige have increased in my village because now I use mobile phone”

20. ImTeCHO is effective N= 50/28 N= 50/28 N= 50/28 N= 95/92 N= 13/8

21. ASHAs are using ImTeCHO regularly

22. Quality of HBNC visit in ImTeCHO (n=14)

23. Technology
Application is powered by ArguSoft India Ltd's mAID platform
Web application uses PostgreSQL version 8.4
databases used are in the are open-source domain RDBMS
Web-application is accessible thru the internet while the Mobile Devices use 2G GPRS network for data synch
No major crash/technology glitch so far

24. Implementation plan Preparation phase Training phase Maintenance phase
Mobile connectivity
Gather information about all users
Purchase of mobiles etc
Taking all stakeholders in confidence
Training phase
Training of ASHAs and PHC staff (7 days)
Mentoring (2-3 weeks per PHC)
Certification (1-2 weeks)
Maintenance phase
Ongoing facilitation from SEWA Rural facilitator
Regular use of ImTeCHO by all users

25. Proposal for Narmada district
Joint initiative between DHS and SEWA Rural
Phase wise implementation (3 phases) starting in October, 2014 with Sagbara
Active facilitation from SEWA Rural (training, ongoing technology support etc)
Research in collaboration of ICMR/WHO
Except 5 PHCs, good GPRS signal in district
Expense of phase 1 and 2 will be bourn by SEWA Rural (ICMR/WHO)

26. Recognition of ImTeCHO
“One of the most comprehensive mHealth intervention”: Dr.Marc Mitchell (Harvard schoold of public health)
Nominated for two e-governance award
Featured in m-governance booklet of GoG

27. Other considerations Interoperable Feedback/grievance redressal system
Activity and financial audit trail
Adaptable and scalable
Clear roll out plan as PPP model
Secure system and confidentiality of medical information

28. Please visit www.imtecho.com
Acknowledgements
ASHAs and PHC staff of Jhagadia and Moriyana PHCs along with people of Jhagadia
Department of Health and Family Welfare, GoG
Argusoft India Ltd
Jamsetji Tata Trust
Please visit