For female health workers in India, a new digital tool puts data at their fingertips

India’s Auxiliary Nurse Midwives (ANMs) are village-level female health workers who provide essential primary care services to pregnant women, mothers and newborn children. A new tablet application is helping them log healthcare data.

By Idhries Ahmad
A group of Auxiliary Nurse Midwives (ANMs) in India holding tablets.
UNICEF India/2016

20 April 2016

VIJAYAWADA, India, 20 April 2016 – For more than two decades now, 45-year-old Padmavati has been visiting pregnant women, mothers and newborn children in the Vijayawada district of the southern Indian state of Andhra Pradesh. With her, she carries several hardback paper registers – one for each village she visits – and carefully logs healthcare data as she goes.

Padmavati is one of 293,000 Auxiliary Nurse Midwives (ANMs) in India – village-level female health workers who are the first contact persons between the community and the health services of India. 
  

ANMs cater to populations of 3,000-5,000 people, and their work mainly involves providing primary healthcare services for maternal and child health, family planning, nutrition and immunization programmes.

Another extremely important part of the job is collecting healthcare data. ANMs capture around 200 key indicators related to health, nutrition and immunization of pregnant women, mothers and newborn children in their paper registers.

Like many other ANMs, Padmavati handles more than one village, and on an average day carries 12-15 separate registers to record key data indicators 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.

Manually updating the data carries the additional risk of information being entered incorrectly and getting corrupted.
  

Bringing ANMs online

In an effort to improve data collection and the overall standards of child and maternal health service provision in India, the Ministry of Health and Family Welfare, with support from UNICEF, has introduced an android-based tablet application called ANMOL.

ANMOL or ANM Online is a solution that aims to bring better healthcare services to millions of pregnant women, mothers and newborns in India.

The application ends drudgery and repetitive processes for ANMs by making their work paperless. They are able to use the tablets to enter and update the service records of beneficiaries on real time basis, ensuring prompt data entry and updates. Since it is a completely digitalized process, the high quality of the data and accountability is maintained.

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An ANM holds a tablet displaying the ANMOL application.

All of the data that ANMs put into the tablets gets updated automatically in the central server. In the event of an internet outage, the tablets will work in offline mode, saving all of the data until internet connectivity is reestablished.

“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.”

In addition to data collection, the tablets have a number of other key functions. They complement ANMs’ roles as counselors by providing readily available information about newborns, pregnant women and mothers in their areas.

ANMs can also use pre-loaded audio and video files on ANMOL to counsel women and couples on subjects like high-risk pregnancies, immunization and family planning. The tablets maintain an auto-generated list of pending tasks as well.
  

A digital India

Sujatha works as an ANM in the same district as Padmavati. She is one of the many ANMs who took part in ANMOL’s pilot program, introduced by the Government of India in the state of Andhra Pradesh.

Like other ANMs, Sujatha was apprehensive about learning the functions of the ANMOL tablet and was unsure whether she would be able to operate it properly.

Happily, after attending the training sessions conducted by the Indian Government and the UNICEF technical support team, Sujatha now finds the tablet easier to use than the paper registers.

“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,” Sujatha says.

Sujatha has gained new confidence as she goes around the villages, counselling women and couples using videos and audio functions of the tablet.

“The ANMOL tablet is like my akka [elder sister in Telugu], a constant guiding support that helps me overcome my day-to-day issues.”

On World Health Day this year, India’s Minister for Health and Family Welfare, Mr. Jagat Prakash 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," he said.

“The ANMOL application will help implement health programmes successfully at the grassroots level.”

The Government of India is now planning a phased roll-out of ANMOL to all 293,000 ANMs in the country.