Strengthening of Home Based Post-natal care by ASHAs using mobile phone technology in two districts of Haryana
Since 2013, a sturdy system has been developed jointly by NHM Haryana and SWACH in which all pregnancies and its outcomes in two districts Ambala and Yamuna Nagar are reported to SWACH by 1650 ASHA by mobile phone in an ongoing manner.
As a result of collaborative efforts, more than 150,000 births have been recorded to date. It has helped to improve understanding of adverse feto-maternal outcomes in the form of abortions, miscarriages, still births neonatal deaths, low birth weight and prematurity and birth defects.
The findings of the implementation science highlight the importance of greater stress on reduction of adverse feto maternal outcomes in India to achieve SDGs (2030).
This collaborative effort has made it possible to improve the reporting of early pregnancy, encourage full coverage with institutional deliveries, and promote early breast feeding and skin to skin contact, universal recording of birth weight and provision of sustained support to the mother and the baby as a dyad in the post-natal period. The neonatal mortality rate in the rural areas has declined from 22 to about 19/1000 live births.
The neonatal mortality has shown a declining trend. The main decline has occurred during 8-28 days age. This is attributed to improved home based care and timely care seeking by the families at the time of illness. Our study has demonstrated that program should focus on babies less than 2000 grams birth weight who are at high risk of death. In addition, babies born with birth defects (about 1%) and the survivors of babies who are asphyxiated at the time of birth require intensive follow up care.
A follow up of more than 4000 babies born below 2000 grams at birth has shown that those who survive require ongoing nurturing care by the family supported by health workers. As a result of our efforts, it has been possible to sustain good growth trajectories in more than 90% of low birth weight babies even though they continue to be undernourished. As a result of these collaborative efforts, a large cohort of mothers and children of different age group in the rural areas in two districts has been established.
The system can be used for health promotion and monitoring for nurturing care and ECD (exclusive breast feeding, vaccination, complementary feeding, promote mothers health and happiness)