Healthcare app to improve maternal an infant health in India

The Wellcome Trust has funded the development of a mobile healthcare app called ‘DRISTHI’ to help track maternal and infant health in rural India. Deborah Hawkes, from the Technology Transfer team at the Wellcome Trust, travelled to India to see how the pilot phase of the project was being implemented.

Greetings from southern India! We could still hear the dawn prayers when Dr Shirshendu Mukherjee and myself set out from our Bangalore hotel in the early morning. Our destination was a primary health centre in a remote village called Bherya in rural Karnataka state, about four hours drive away. There we met up with our collaborative project partners from Columbia University (CU), the World Health Organisation’s Department of Reproductive Health and Research (WHO) and the Foundation for Research in Health Systems (FRHS) to see how the DRISTHI project is progressing.

Funded by the Wellcome Trust’s  Affordable Healthcare in India initiative, this multidisciplinary collaborative team have designed and built a healthcare app for tablet devices to help health workers in rural India. Built entirely from scratch, the app is currently being piloted with female health workers called Auxiliary Nurse Midwives (ANMs).

ANMs work at the community level monitoring and treating pregnant women and their infants. Each ANM serves a rural population of three to five thousand women and children and they currently use paper-based reporting registries to keep track of all their patients.

As you might imagine, the paperwork that has to be completed for each patient is considerably burdensome and time-consuming. Each ANM carries a large stack of these paper records around with her, and this gets in the way of treating such high volumes of patients. The mobile-health app, named DRISTHI, replaces the need for carrying these heavy stacks of paper registers, while enabling real-time updating and reporting of patient records.

There is a clear need to address infant and maternal mortality in areas like this where the nearest hospital might be several hours away and DRISTHI is designed to track maternal health throughout a woman’s pregnancy. It can also flag any high-risk patients so that they can be more effectively monitored and treated in real-time. For example, if the patient has experienced complications during a previous pregnancy, is anaemic or experiencing high blood pressure. The app also helps to ensure that mothers and infants receive all their necessary vaccinations, iron supplementation and medical check-ups by using alerts and automated reporting.

During our visit, Shirshendu and I were able to see DRISTHI in action in Bherya and Keelanapura villages where it was vaccination day. The ANMs were using the app on tablets to record which infants were receiving their vaccinations and whether they had received their full courses. It was certainly not a quiet experience – the tiny patients certainly made their presence known!

While the DRISTHI app is still in pilot testing, the collaborative team from CU, WHO and FRHS are preparing the ground for a larger controlled field trial due to commence later in 2014. The team aims to sample 10,000 patients who will be seen by health workers using the app, and monitor their health outcomes over the course of a year.

Our thanks go to the entire team at FRHS, WHO and CU for their dedication to the project and for making our visit possible. I would like to acknowledge the direction and efforts of Dr Nirmala Murthy, Professor Vijay Modi, Dr Garrett Mehl, Mr Matthew Berg and Dr Suresh Reddy.

We very much look forward to seeing the technology progress to aid the difficult job of the ANMs and ultimately improve the health of women and children in rural India and beyond.

This project is funded by the Wellcome Trust’s Affordable Healthcare in India initiative, which supports translational research projects to deliver safe and effective healthcare products for India at an affordable cost. You can find out more about this funding and how to apply on the Wellcome Trust website.