WHY ImTeCHO


ImTeCHO is an innovative strategy to overcome above problems by using mobile phone technology (called mHealth solutions) to empower ASHAs. ImTeCHO will be used in 3 ways:

  1. Mobile phone as a job aid (ImTeCHO) to ASHAs to increase coverage of maternal, newborn and child care
  2. Mobile phone as a job aid (ImTeCHO) to ASHAs and Auxiliary Nurse Midwives to facilitate referral and care for mother, newborn and child with complications
  3. Web interface as job-aid (ImTeCHO) to PHC staff for monitoring and supporting ASHA program, including timely ASHA incentive payment, supply management, ASHA performance report, and accurate reporting of births and deaths.

What is the problem that ImTeCHO addresses?

Over the course of last decade, significant evidence has been generated about effectiveness of community based interventions which can reduce maternal, newborn, and child mortality and morbidity. To facilitate implementation of the proven interventions, a new cadre of village based Community Health Workers, called Accredited Social Health Activist (ASHA), has been created under the aegis of the National Rural Health Mission (NHRM). Many of the community based maternal, newborn and child health (MNCH) interventions are expected to be delivered or facilitated by ASHA during her scheduled home visits.

Unfortunately, evaluations examining ASHA’s performance have noted that coverage of selected MNCH interventions to be implemented by ASHA is suboptimal. Some of the critical reasons for low coverage is inadequate support and supportive supervision of ASHAs inadequate information about performance, delay and insufficient payment of incentives, poor knowledge and skills of ASHAs, quality of training, and complexity of tasks to be performed [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) National Health Systems Resource Centre (NHSRC) and National Rural Health Mission (NRHM). An update on ASHA programme. New Delhi, January, 2013] Also, timely identification of sickness / complications and risk screening among large numbers of maternal, newborn and child cases is much to be desired and many do not reach to appropriate health facility. The non-availability of real time information about such cases to respective Auxiliary Nurse Midwife (ANMs) and medical officers has limited their ability to respond; hence, such complicated cases at home tend not to receive appropriate care.

COMPONENTS OF IMTECHO

COMPONENTS IMTECHO
Decision support system yes YES
Awareness raising yes YES
Surveillance yes YES
Patient monitoring and high risk tracking yes YES
Programme management tool yes YES
Patient record yes YES
Treatment compliance yes YES
Community mobilization yes YES
Appointment (home visits) reminders yes YES
Emergencies yes YES

Implementation

Piloting of ImTeCHO began in May, 2013 in two tribal PHCs of Jhagadia block of Bharuch district in Gujarat. Over last four years, the project was gradually scale up and 500 ASHAs are currently using ImTeCHO application daily. The project has been evaluated using robust research methodologies. Now, the government is planning to scale up statewide in phase wise manner.

BENEFITS


Support to ASHA's

  • Provision of daily schedule makes planning of home visits easy
  • No need to remember every small details from ASHA module 6 and 7 as mobile reminds what tasks to be completed during home visits
  • In-built videos makes counselling easy and effective
  • Relieves ASHAs from remembering complex algorithms as customised diagnosis, risk stratification and treatment plan, including doses of drugs are available in mobile
  • Easy calculation of incentives and regular replenishment of supply
  • E-ASHA diary in mobile stores record of task completed which can be used in place of current ASHA diary

Support to Female Health workers/Auxiliary Nurse Midwives?

  • Reporting and recording is now easy
  • Planning of monthly village health and nutrition day is easy and effective
  • e-mamata card will be prepared automatically for every beneficiary on web interface
  • Instant notification of at risk mothers and children so that FHWs can plan their field visit accordingly