April 2012
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public GrievancesMinistry of Personnel, Public Grievances and Pensions, Government of Indiahttp://indiagovernance.gov.in/
Researched and Documented by
OneWorld Foundation India
AarogyamDigital Health Mapping and Service Delivery
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
Table of Contents EXECUTIVE SUMMARY ................................
METHODOLOGY ................................
BACKGROUND ................................
OBJECTIVE ................................................................
PROGRAMME DESIGN ................................
KEY STAKEHOLDERS ................................
WORK FLOW ................................
MOTHER AND CHILD TRACKING FACILITY
PROVISION OF ADEQUATE
CAPACITY BUILDING AND
MONITORING AND EVALUATION
TECHNOLOGY UTILISED
FUNDING ................................
IMPACT ................................................................
IMPROVING ACCOUNTABIL
EMPOWERING THE COMMUN
BETTERING THE MATERNA
PROVIDING A REPLICABLE MODEL FOR IMPROVIN
CHALLENGES IN IMPLEMENTATION
CONCLUSION ................................
REFERENCES ................................
APPENDIX A – INTERVIEW QUESTIONNAIRE
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
................................................................................................
................................................................................................................................
................................................................................................................................
................................................................................................
................................................................................................
................................................................................................
................................................................................................................................
TRACKING FACILITY ................................................................
ROVISION OF ADEQUATE HEALTHCARE FACILITIES ................................................................
APACITY BUILDING AND COMMUNITY AWARENESS GENERATION ................................
VALUATION ................................................................
GY UTILISED ................................................................................................
................................................................................................................................
................................................................................................
MPROVING ACCOUNTABILITY AND RESPONSIBILITY OF HEALTH SERVICE
MPOWERING THE COMMUNITY ................................................................................................
ETTERING THE MATERNAL AND CHILD HEALTH SCENARIO IN U.P ................................
E MODEL FOR IMPROVING DELIVERY OF HEALTH
MPLEMENTATION ................................................................................................
................................................................................................................................
................................................................................................................................
UESTIONNAIRE ................................................................
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
1
................................................................ 2
.......................................... 2
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........................................................ 9
TY OF HEALTH SERVICE PROVIDERS ............... 9
.................................... 10
.......................................... 10
G DELIVERY OF HEALTH SERVICES ................ 11
........................................ 11
............................................ 12
.............................................. 12
.......................................................... 14
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
EXECUTIVE SUMMARYThe Infant Mortality Rate and Maternal Mortality rate in Uttar Pradesh (U.P) is amongst the
highest in the country.1 The lack of access to adequate facilities combines with the unawareness
of the rural population in the state to make the maternal and infant health situation abysmal.
Aarogyam, an ICT based health related service delivery provision system, seeks to corre
problem of high incidences of maternal and infant deaths in U.P by tracking women's
pregnancies and maintaining a record of child immunisation over time. It was initiated in
Baghpat and J.P. Nagar districts of the state in 2008.
Under Aarogyam, a village wise database of all the beneficiaries (pregnant/lactating women,
children up to 5 years) of an area is maintained, which gets continually updated. Based on this
database, the Aarogyam software sends automated alerts in the form of vernacular voic
calls/SMS to the beneficiaries informing and reminding them about their pending antenatal and
postnatal care and immunisation appointments. These alerts are also sent to local level health
officials informing them about due services in the area.
Aarogyam also has an in-dial facility where beneficiaries can call up to inquire about any
maternal and infant related health issues and also file their grievances. These grievances are
registered under the Management Information System (MIS) of Aarogyam that prov
basis for concerned health professionals to take related corrective measures.
In this manner, Aarogyam is ensuring that the government reaches out to people with pro
active and responsive health care delivery.
districts of the state, making health professionals accountable along with empowering the
community with adequate reproductive and infant health related information. Given its
remarkable performance, Aarogyam has received several awards and rec
NASSCOM Social Innovation Honors 2010 and the M
METHODOLOGY The Governance Knowledge Centre (GKC) documents best practices in governance in India in
support of further replication. For this purpose, select initiatives that are significantly
1Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India. Sample
Registration Survey (SRS). July. 2011. Web. April 29. 2011. <
http://censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR_release_070711.pdf
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
UMMARY The Infant Mortality Rate and Maternal Mortality rate in Uttar Pradesh (U.P) is amongst the
The lack of access to adequate facilities combines with the unawareness
of the rural population in the state to make the maternal and infant health situation abysmal.
Aarogyam, an ICT based health related service delivery provision system, seeks to corre
problem of high incidences of maternal and infant deaths in U.P by tracking women's
pregnancies and maintaining a record of child immunisation over time. It was initiated in
Baghpat and J.P. Nagar districts of the state in 2008.
village wise database of all the beneficiaries (pregnant/lactating women,
children up to 5 years) of an area is maintained, which gets continually updated. Based on this
database, the Aarogyam software sends automated alerts in the form of vernacular voic
calls/SMS to the beneficiaries informing and reminding them about their pending antenatal and
postnatal care and immunisation appointments. These alerts are also sent to local level health
officials informing them about due services in the area.
dial facility where beneficiaries can call up to inquire about any
maternal and infant related health issues and also file their grievances. These grievances are
registered under the Management Information System (MIS) of Aarogyam that prov
basis for concerned health professionals to take related corrective measures.
In this manner, Aarogyam is ensuring that the government reaches out to people with pro
active and responsive health care delivery. Aarogyam has today been expanded to
districts of the state, making health professionals accountable along with empowering the
community with adequate reproductive and infant health related information. Given its
remarkable performance, Aarogyam has received several awards and rec
NASSCOM Social Innovation Honors 2010 and the M-Billionth Award 2010.
The Governance Knowledge Centre (GKC) documents best practices in governance in India in
support of further replication. For this purpose, select initiatives that are significantly
Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India. Sample
Registration Survey (SRS). July. 2011. Web. April 29. 2011. <
p://censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR_release_070711.pdf>
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
2
The Infant Mortality Rate and Maternal Mortality rate in Uttar Pradesh (U.P) is amongst the
The lack of access to adequate facilities combines with the unawareness
of the rural population in the state to make the maternal and infant health situation abysmal.
Aarogyam, an ICT based health related service delivery provision system, seeks to correct this
problem of high incidences of maternal and infant deaths in U.P by tracking women's
pregnancies and maintaining a record of child immunisation over time. It was initiated in
village wise database of all the beneficiaries (pregnant/lactating women,
children up to 5 years) of an area is maintained, which gets continually updated. Based on this
database, the Aarogyam software sends automated alerts in the form of vernacular voice
calls/SMS to the beneficiaries informing and reminding them about their pending antenatal and
postnatal care and immunisation appointments. These alerts are also sent to local level health
dial facility where beneficiaries can call up to inquire about any
maternal and infant related health issues and also file their grievances. These grievances are
registered under the Management Information System (MIS) of Aarogyam that provides the
basis for concerned health professionals to take related corrective measures.
In this manner, Aarogyam is ensuring that the government reaches out to people with pro-
Aarogyam has today been expanded to about eight
districts of the state, making health professionals accountable along with empowering the
community with adequate reproductive and infant health related information. Given its
remarkable performance, Aarogyam has received several awards and recognitions like the
Billionth Award 2010.
The Governance Knowledge Centre (GKC) documents best practices in governance in India in
support of further replication. For this purpose, select initiatives that are significantly
Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India. Sample
>
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
contributing towards the betterment of public service delivery are identifi
research team. The team conducted extensive secondary research using credible web sources to
establish the suitability of Aarogyam
in Uttar Pradesh - as a best practice. This research r
successfully harnessing information and communication technology tools to create a pregnancy
tracking database for facilitating the timely delivery of crucial maternal and infant related
health services.
Having recognised Aarogyam as a best practice, the key stakeholders in the initiative were
identified and interviewed to gain a deeper insight into the operation and impact of the
initiative. This document has been created by compiling the information collected thro
secondary research as well as the insights gathered through an interview with the Managing
Director of Kanpur State Electricity Company Limited (KESCO) who, along with the District
Magistrate of Kanpur-Dehat, was responsible for initiating and implemen
Baghpat and J.P.Nagar.
Efforts have been made to provide objective information in the document. However, since only
the implementers of the project were interviewed, there is a possibility of percolation of
information bias.
BACKGROUND Providing accessible and qualitative healthcare to an increasingly vast population remains a
humongous task for service providers in India. Among the foremost healthcare challenges that
the country faces is the high rate of maternal and infant mortality. As p
Registration System (SRS)2, India’s Infant Mortality Rate (IMR)
2010) while its Maternal Mortality Rate (MMR)
As identified by the National Family Health Survey (NH
reasons behind such high incidences of infant and maternal deaths in India are the lack of
awareness among women about the importance of antenatal care (ANC) and postnatal care
(PNC), inadequate infrastructural as well a
2 THE SAMPLE REGISTRATION SYSTEM (SRS)
ESTIMATES OF BIRTH RATE, DEATH RATE AND OTHER
NATIONAL LEVELS. <
HTTP://CENSUSINDIA.GOV.IN/VITAL_STATISTICS3 Number of infant deaths per 1000 live births4 NUMBER OF MATERNAL DEATHS PER 1,00,000
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
contributing towards the betterment of public service delivery are identifi
research team. The team conducted extensive secondary research using credible web sources to
establish the suitability of Aarogyam - a pregnancy tracking and digital health mapping system
as a best practice. This research reflected the manner in which Aarogyam is
successfully harnessing information and communication technology tools to create a pregnancy
tracking database for facilitating the timely delivery of crucial maternal and infant related
ognised Aarogyam as a best practice, the key stakeholders in the initiative were
identified and interviewed to gain a deeper insight into the operation and impact of the
initiative. This document has been created by compiling the information collected thro
secondary research as well as the insights gathered through an interview with the Managing
Director of Kanpur State Electricity Company Limited (KESCO) who, along with the District
Dehat, was responsible for initiating and implemen
Efforts have been made to provide objective information in the document. However, since only
the implementers of the project were interviewed, there is a possibility of percolation of
viding accessible and qualitative healthcare to an increasingly vast population remains a
humongous task for service providers in India. Among the foremost healthcare challenges that
the country faces is the high rate of maternal and infant mortality. As p
, India’s Infant Mortality Rate (IMR)3 is 47 per 1000 live births (in
2010) while its Maternal Mortality Rate (MMR)4 is 212 per 100,000 live births (2007
As identified by the National Family Health Survey (NHFS)-2 of the year 1998
reasons behind such high incidences of infant and maternal deaths in India are the lack of
awareness among women about the importance of antenatal care (ANC) and postnatal care
(PNC), inadequate infrastructural as well as medical facilities and assistance during delivery,
(SRS) IS A LARGE-SCALE DEMOGRAPHIC SURVEY FOR PROVIDING R
DEATH RATE AND OTHER FERTILITY & MORTALITY INDICATORS AT THE NATIONA
TATISTICS/SRS_BULLETINS/SRS%20BULLETIN_%20DECEMBER
live births
1,00,000 LIVE BIRTHS
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
3
contributing towards the betterment of public service delivery are identified by the GKC
research team. The team conducted extensive secondary research using credible web sources to
a pregnancy tracking and digital health mapping system
eflected the manner in which Aarogyam is
successfully harnessing information and communication technology tools to create a pregnancy
tracking database for facilitating the timely delivery of crucial maternal and infant related
ognised Aarogyam as a best practice, the key stakeholders in the initiative were
identified and interviewed to gain a deeper insight into the operation and impact of the
initiative. This document has been created by compiling the information collected through
secondary research as well as the insights gathered through an interview with the Managing
Director of Kanpur State Electricity Company Limited (KESCO) who, along with the District
Dehat, was responsible for initiating and implementing Aarogyam in
Efforts have been made to provide objective information in the document. However, since only
the implementers of the project were interviewed, there is a possibility of percolation of
viding accessible and qualitative healthcare to an increasingly vast population remains a
humongous task for service providers in India. Among the foremost healthcare challenges that
the country faces is the high rate of maternal and infant mortality. As per the Sample
is 47 per 1000 live births (in
is 212 per 100,000 live births (2007-2009).
2 of the year 1998-99, the main
reasons behind such high incidences of infant and maternal deaths in India are the lack of
awareness among women about the importance of antenatal care (ANC) and postnatal care
s medical facilities and assistance during delivery,
RVEY FOR PROVIDING RELIABLE ANNUAL
ATORS AT THE NATIONAL AND SUB-
ECEMBER%202011%20.PDF/>
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
incomplete immunisation and improper treatment of birth related problems among infants,
and provision of service by under
combine with under utilisation of technology and marginal involvement of communities and
other stakeholders in the health system to result in a unidirectional, unresponsive supply based
health service delivery approach.
Hoping to address these shortcomings, the Government of India
Reproductive and Child Healthcare (RCH) Programme in 1997
maternal and child health in the country. In April 2005, this RCH programme was integrated
within the National Rural Health Mission (NRHM) to take for
motherhood and child survival. Under NRHM, the
that seeks to address problems of maternal mortality and infant mortality by providing cash
incentives to women who choose institutional deliv
that both the mother and child are provided with adequate care (ANC and PNC) and medical
facilities (medicines and immunisation) that they would otherwise be deprived of in case of
home based deliveries with the assistance of a mid
However, in spite of such national level schemes, states all across India have failed to follow a
streamlined approach to reach the targeted population. The absence of a proper tracking
process results in many women and childre
care schemes. In instances where the target population is being adequately reached out to, there
is a lack of follow up mechanisms because of the failure to maintain an appropriate database.
Recognising these shortcomings, most Indian states have been devising new processes and
mechanisms to meet their commitments under the NRHM. An interesting development of late
has been the use of information and communication technology (ICT) tools for improving the
delivery of health related services.
One such initiative that is successfully leveraging the use of technology for efficient healthcare
delivery in the country is Aarogyam in Uttar Pradesh (U.P). The IMR and MMR in U.P are
amongst the highest in the country.
unawareness of the rural population in the state to make the maternal and infant health
situation abysmal. Developed in 2008, Aarogyam seeks to address this by effectively leveraging
ICT for delivering timely health services.
5 Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India. Sample
Registration Survey (SRS). July. 2011. Web. April 29. 2011. <
http://censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR_release_070711.pdf
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
incomplete immunisation and improper treatment of birth related problems among infants,
and provision of service by under-capacitated health professionals. These factors further
ation of technology and marginal involvement of communities and
other stakeholders in the health system to result in a unidirectional, unresponsive supply based
health service delivery approach.
Hoping to address these shortcomings, the Government of India
Reproductive and Child Healthcare (RCH) Programme in 1997-98 with the goal of improving
maternal and child health in the country. In April 2005, this RCH programme was integrated
within the National Rural Health Mission (NRHM) to take forward the goals of safe
motherhood and child survival. Under NRHM, the Janani Suraksha Yojana
that seeks to address problems of maternal mortality and infant mortality by providing cash
incentives to women who choose institutional delivery. With institutional delivery, it is hoped
that both the mother and child are provided with adequate care (ANC and PNC) and medical
facilities (medicines and immunisation) that they would otherwise be deprived of in case of
he assistance of a mid-wife.
However, in spite of such national level schemes, states all across India have failed to follow a
streamlined approach to reach the targeted population. The absence of a proper tracking
process results in many women and children being left out from the coverage of such health
care schemes. In instances where the target population is being adequately reached out to, there
is a lack of follow up mechanisms because of the failure to maintain an appropriate database.
se shortcomings, most Indian states have been devising new processes and
mechanisms to meet their commitments under the NRHM. An interesting development of late
has been the use of information and communication technology (ICT) tools for improving the
very of health related services.
One such initiative that is successfully leveraging the use of technology for efficient healthcare
delivery in the country is Aarogyam in Uttar Pradesh (U.P). The IMR and MMR in U.P are
amongst the highest in the country.5 The lack of adequate facilities combines with the
unawareness of the rural population in the state to make the maternal and infant health
situation abysmal. Developed in 2008, Aarogyam seeks to address this by effectively leveraging
mely health services.
Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India. Sample
Registration Survey (SRS). July. 2011. Web. April 29. 2011. <
http://censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR_release_070711.pdf>
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
4
incomplete immunisation and improper treatment of birth related problems among infants,
capacitated health professionals. These factors further
ation of technology and marginal involvement of communities and
other stakeholders in the health system to result in a unidirectional, unresponsive supply based
Hoping to address these shortcomings, the Government of India (GOI) launched a
98 with the goal of improving
maternal and child health in the country. In April 2005, this RCH programme was integrated
ward the goals of safe
Janani Suraksha Yojana is a crucial scheme
that seeks to address problems of maternal mortality and infant mortality by providing cash
ery. With institutional delivery, it is hoped
that both the mother and child are provided with adequate care (ANC and PNC) and medical
facilities (medicines and immunisation) that they would otherwise be deprived of in case of
However, in spite of such national level schemes, states all across India have failed to follow a
streamlined approach to reach the targeted population. The absence of a proper tracking
n being left out from the coverage of such health
care schemes. In instances where the target population is being adequately reached out to, there
is a lack of follow up mechanisms because of the failure to maintain an appropriate database.
se shortcomings, most Indian states have been devising new processes and
mechanisms to meet their commitments under the NRHM. An interesting development of late
has been the use of information and communication technology (ICT) tools for improving the
One such initiative that is successfully leveraging the use of technology for efficient healthcare
delivery in the country is Aarogyam in Uttar Pradesh (U.P). The IMR and MMR in U.P are
The lack of adequate facilities combines with the
unawareness of the rural population in the state to make the maternal and infant health
situation abysmal. Developed in 2008, Aarogyam seeks to address this by effectively leveraging
Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India. Sample
Registration Survey (SRS). July. 2011. Web. April 29. 2011. <
>
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
‘Aarogyam’ is a Sanskrit word that means ’complete freedom from illness’. An ICT based
responsive system, Aarogyam, ensures active participation of all key stakeholders viz. local
administration, doctors, frontline health workers
ANM (Auxiliary Nurse Midwife), and AWW (Anganwadi Workers)
beneficiaries, to ensure that a pregnant woman is provided with ANC, PNC and that children
are given complete immunisation.
Aarogyam maintains a village wise database of all the beneficiaries (pregnant/lactating women,
children up to 5 years) of an area, which gets continually updated. Based on this database, the
Aarogyam software sends automated alerts in the form of vernacular voice ca
beneficiaries informing them about their pending appointments. These alerts are also sent to
local level health officials informing them about medical services due in the area. In this
manner, Aarogyam ensures that the government reaches out
care delivery services. Initiated in two districts of U.P
today been expanded to about eight districts of the state.
OBJECTIVE Aarogyam is an ICT based health care delivery system for pregnancy tracking and digital
health mapping. It has the following objectives:
• Tracking each pregnancy in the target areas with the help of a technology based
monitoring system
• Ensuring complete ante and
institutional deliveries
• Providing 100 percent immunisation for pregnant women and children in the age group
0-5 years
• Developing a two-way demand based interactive health care delivery eco
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
‘Aarogyam’ is a Sanskrit word that means ’complete freedom from illness’. An ICT based
responsive system, Aarogyam, ensures active participation of all key stakeholders viz. local
administration, doctors, frontline health workers - ASHA (Accredited Social Health Activists),
ANM (Auxiliary Nurse Midwife), and AWW (Anganwadi Workers)
beneficiaries, to ensure that a pregnant woman is provided with ANC, PNC and that children
are given complete immunisation.
aintains a village wise database of all the beneficiaries (pregnant/lactating women,
children up to 5 years) of an area, which gets continually updated. Based on this database, the
Aarogyam software sends automated alerts in the form of vernacular voice ca
beneficiaries informing them about their pending appointments. These alerts are also sent to
local level health officials informing them about medical services due in the area. In this
manner, Aarogyam ensures that the government reaches out to people with responsive health
Initiated in two districts of U.P - Baghpat and J.P Nagar
today been expanded to about eight districts of the state.
is an ICT based health care delivery system for pregnancy tracking and digital
health mapping. It has the following objectives:
Tracking each pregnancy in the target areas with the help of a technology based
Ensuring complete ante and post natal care for pregnant women and promoting
institutional deliveries
Providing 100 percent immunisation for pregnant women and children in the age group
way demand based interactive health care delivery eco
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
5
‘Aarogyam’ is a Sanskrit word that means ’complete freedom from illness’. An ICT based
responsive system, Aarogyam, ensures active participation of all key stakeholders viz. local
ASHA (Accredited Social Health Activists),
ANM (Auxiliary Nurse Midwife), and AWW (Anganwadi Workers) -village heads and
beneficiaries, to ensure that a pregnant woman is provided with ANC, PNC and that children
aintains a village wise database of all the beneficiaries (pregnant/lactating women,
children up to 5 years) of an area, which gets continually updated. Based on this database, the
Aarogyam software sends automated alerts in the form of vernacular voice calls/SMS to the
beneficiaries informing them about their pending appointments. These alerts are also sent to
local level health officials informing them about medical services due in the area. In this
to people with responsive health
Baghpat and J.P Nagar - Aarogyam has
is an ICT based health care delivery system for pregnancy tracking and digital
Tracking each pregnancy in the target areas with the help of a technology based
post natal care for pregnant women and promoting
Providing 100 percent immunisation for pregnant women and children in the age group
way demand based interactive health care delivery eco-system
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
PROGRAMME DESIGN
KEY STAKEHOLDERS
• Rural health workers like
Nurse Midwife), and AWW (Anganwadi Workers):
aggregation and updation of data related to
that related health services are delivered in a timely manner.
• Data operators at the Block and District level:
health workers is entered correctly in the Aarogyam software.
• Complete Healthcare Centres (CHCs) and Primary Healthcare Centres (PHCs) at the
Block Level: Rural health workers associated with CHCs and PHCs leverage their facilities
to deliver healthcare to mothers and infants. CHCs and PHCs also act as centres for data
aggregation.
• Village Pradhans: Aarogyam keeps the
infant health related services, who then use the information to ensure timely delivery of
services.
• Beneficiaries: These include pregnant and lactating women an
of age.
• Private software companies
software.
• National Informatics Centre (NIC)
WORK FLOW
Aarogyam has two crucial components a) mother and child tracking facility b) provision of
adequate healthcare facilities to mothers and children below five years of age.
MOTHER AND CHILD TRAC
The beginning point for health delivery services under Aarogyam
maternal and child health related information within the target area. For this purpose, a
comprehensive baseline health survey of households in the targeted districts was conducted.
Data was collected on the basis of gender, religion
aspects like immunisation details of infants and pregnancy related information with expected
date of deliveries along with the services availed by a pregnant women till that time.
time of the survey, each beneficiary was given an 8 digits unique ID that consists of block id
(first two digits) + village id (second two digits) + beneficiary id (last four digits). This unique
ID is used for tracking the health of a mother and her child in the system.
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
ESIGN
Rural health workers like ASHA (Accredited Social Health Activists), ANM (Auxiliary
Nurse Midwife), and AWW (Anganwadi Workers): They play a crucial role in
aggregation and updation of data related to pregnant women and infant
that related health services are delivered in a timely manner.
Data operators at the Block and District level: They ensure that the data collected by rural
health workers is entered correctly in the Aarogyam software.
Healthcare Centres (CHCs) and Primary Healthcare Centres (PHCs) at the
Rural health workers associated with CHCs and PHCs leverage their facilities
to deliver healthcare to mothers and infants. CHCs and PHCs also act as centres for data
Aarogyam keeps the Pradhans informed about the status of maternal and
infant health related services, who then use the information to ensure timely delivery of
include pregnant and lactating women and children below five years
Private software companies: They have been responsible for development
National Informatics Centre (NIC): It supervises the overall functioning of the software.
l components a) mother and child tracking facility b) provision of
adequate healthcare facilities to mothers and children below five years of age.
OTHER AND CHILD TRACKING FACILITY
The beginning point for health delivery services under Aarogyam was the collection of
maternal and child health related information within the target area. For this purpose, a
comprehensive baseline health survey of households in the targeted districts was conducted.
Data was collected on the basis of gender, religion, caste and 13 health indicators that included
aspects like immunisation details of infants and pregnancy related information with expected
date of deliveries along with the services availed by a pregnant women till that time.
ch beneficiary was given an 8 digits unique ID that consists of block id
(first two digits) + village id (second two digits) + beneficiary id (last four digits). This unique
ID is used for tracking the health of a mother and her child in the system.
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
6
ASHA (Accredited Social Health Activists), ANM (Auxiliary
They play a crucial role in collection,
and infants, and in ensuring
They ensure that the data collected by rural
Healthcare Centres (CHCs) and Primary Healthcare Centres (PHCs) at the
Rural health workers associated with CHCs and PHCs leverage their facilities
to deliver healthcare to mothers and infants. CHCs and PHCs also act as centres for data
informed about the status of maternal and
infant health related services, who then use the information to ensure timely delivery of
d children below five years
They have been responsible for development of the Aarogyam
supervises the overall functioning of the software.
l components a) mother and child tracking facility b) provision of
adequate healthcare facilities to mothers and children below five years of age.
was the collection of
maternal and child health related information within the target area. For this purpose, a
comprehensive baseline health survey of households in the targeted districts was conducted.
, caste and 13 health indicators that included
aspects like immunisation details of infants and pregnancy related information with expected
date of deliveries along with the services availed by a pregnant women till that time. At the
ch beneficiary was given an 8 digits unique ID that consists of block id
(first two digits) + village id (second two digits) + beneficiary id (last four digits). This unique
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
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Government of India
The ANMs were responsible for conducting the baseline health survey according to a
prescribed format that helped in creating a village wise database of beneficiaries along with
vital health indicators, pregnancy status and contact details. This database is house
office of the Chief Medical Officer (CMO) at the district level. At the village level, ANMs
maintain the Aarogyam register, which contains village wise beneficiary details with the
expected date of delivery and dates of actual and expected ANC/PNC
etc.
Once the process of creating this initial database was completed, a systematic data upgrading
process was designed. Every month the data collection formats are filled by ANMs, unique IDs
given to new beneficiaries and completed forms are submitted to the block PHC/CHC where
the data entry operator consolidates village wise data in pre
Once the Excel sheets are prepared, the data entry operator at the CMO office enters block
data into the Aarogyam software as per the excel sheets. This data is presented in the
Management Information System (MIS), that is, the web
Aarogyam, and can be accessed by key health professionals.
PROVISION OF ADEQUATE
Out-dialling facility
Once the data of a family has been entered at the CMO database, every family’s reproductive
and child health status is monitored regularly and alerts are sent through cell phone text
messages and phone calls. Aarogyam u
automatically generates family specific reminder calls and SMSs in Hindi. It disseminates
updates regarding immunisation for children from 0
vaccination delivery and also the ANC/PNC details of pregnant and
the due dates for health service provision. Village
reminders about families currently not covered under maternal and child health service
delivery facilities in order to ensure benefits of t
families within the target areas.
In-dialling facility
Aarogyam also allows beneficiaries to interact with the system. By calling on a toll
number, beneficiaries can gather maternal and child health c
vaccinations, antenatal care, postnatal care, institutional delivery and birth preparedness. This
information has been pre-fed into the system and is provided to the beneficiary free of cost as
per requirement.
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
Ms were responsible for conducting the baseline health survey according to a
prescribed format that helped in creating a village wise database of beneficiaries along with
vital health indicators, pregnancy status and contact details. This database is house
Chief Medical Officer (CMO) at the district level. At the village level, ANMs
maintain the Aarogyam register, which contains village wise beneficiary details with the
expected date of delivery and dates of actual and expected ANC/PNC visits and immunisation
Once the process of creating this initial database was completed, a systematic data upgrading
Every month the data collection formats are filled by ANMs, unique IDs
given to new beneficiaries and completed forms are submitted to the block PHC/CHC where
the data entry operator consolidates village wise data in pre-formatted Microsoft Excel sheets.
nce the Excel sheets are prepared, the data entry operator at the CMO office enters block
data into the Aarogyam software as per the excel sheets. This data is presented in the
Management Information System (MIS), that is, the web-based monitoring por
Aarogyam, and can be accessed by key health professionals.
ROVISION OF ADEQUATE HEALTHCARE FACILITIES
Once the data of a family has been entered at the CMO database, every family’s reproductive
and child health status is monitored regularly and alerts are sent through cell phone text
messages and phone calls. Aarogyam uses an Interactive Voice Response Sys
automatically generates family specific reminder calls and SMSs in Hindi. It disseminates
updates regarding immunisation for children from 0-5 years, the venue and date for
vaccination delivery and also the ANC/PNC details of pregnant and lactating mothers based on
the due dates for health service provision. Village Pradhans and the ANMs are also sent
reminders about families currently not covered under maternal and child health service
delivery facilities in order to ensure benefits of the system are equally distributed among
families within the target areas.
Aarogyam also allows beneficiaries to interact with the system. By calling on a toll
number, beneficiaries can gather maternal and child health care information related to child
vaccinations, antenatal care, postnatal care, institutional delivery and birth preparedness. This
fed into the system and is provided to the beneficiary free of cost as
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
7
Ms were responsible for conducting the baseline health survey according to a
prescribed format that helped in creating a village wise database of beneficiaries along with
vital health indicators, pregnancy status and contact details. This database is housed at the
Chief Medical Officer (CMO) at the district level. At the village level, ANMs
maintain the Aarogyam register, which contains village wise beneficiary details with the
visits and immunisation
Once the process of creating this initial database was completed, a systematic data upgrading
Every month the data collection formats are filled by ANMs, unique IDs
given to new beneficiaries and completed forms are submitted to the block PHC/CHC where
formatted Microsoft Excel sheets.
nce the Excel sheets are prepared, the data entry operator at the CMO office enters block-wise
data into the Aarogyam software as per the excel sheets. This data is presented in the
based monitoring portal designed for
Once the data of a family has been entered at the CMO database, every family’s reproductive
and child health status is monitored regularly and alerts are sent through cell phone text
ses an Interactive Voice Response System (IVRS), which
automatically generates family specific reminder calls and SMSs in Hindi. It disseminates
5 years, the venue and date for
lactating mothers based on
and the ANMs are also sent
reminders about families currently not covered under maternal and child health service
he system are equally distributed among
Aarogyam also allows beneficiaries to interact with the system. By calling on a toll-free helpline
are information related to child
vaccinations, antenatal care, postnatal care, institutional delivery and birth preparedness. This
fed into the system and is provided to the beneficiary free of cost as
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Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
Beneficiaries can also lodge specific health related complaints using the dial
complaints are registered on the Aarogyam MIS and then attended to by in
officials.
CAPACITY BUILDING AND
Standard operating procedures (SOP)
district and block level was done so as to streamline the data capturing, consolidation and
reporting processes. Standardisation of required formats, periodicity of reporting, role
responsibility of the field workers and accountability of health officials were also fixed.
The district administration held several rounds of training workshops for village
ASHA workers and ANMs for disseminating information regarding Aar
beneficiaries.
Community awareness was generated through films, songs,
distribution of pamphlets, display hoardings and such like to disseminate information about
the project.
MONITORING AND EVALUATION
In order to monitor the proper functioning of Aarogyam system, regular
held with key stakeholders to assess the progress. Aarogyam also automatically generates
pending lists with respect to unfulfilled targets for medical officers, ANM
beneficiaries. Based on this list, call alerts and SMSs are sent to all stakeholders every 10 days
till the services are reported as delivered by the system.
The Aarogyam MIS reflects real time data on total number of grievances disposed,
pending in various offices, status of call alerts and SMSs sent on daily basis etc. This
information is regularly accessed by key officials including the CMO and District Magistrate
(DM) who then ensure that any visible gaps in health service d
Technology utilised
The Aarogyam software has the following components:
- Management Information System (MIS) where health related data is uploaded and which
facilitates web based monitoring.
- Interactive Voice Recording system
reminder alerts and responding to help line queries and grievances.
Aarogyam utilises the existing hardware at the PHC, CHC and CMO office. The computers at
these offices are employed for use of the Aarogyam
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
es can also lodge specific health related complaints using the dial
complaints are registered on the Aarogyam MIS and then attended to by in
APACITY BUILDING AND COMMUNITY AWARENESS GENERATION
procedures (SOP) were established and orientation of required officials at
district and block level was done so as to streamline the data capturing, consolidation and
reporting processes. Standardisation of required formats, periodicity of reporting, role
responsibility of the field workers and accountability of health officials were also fixed.
The district administration held several rounds of training workshops for village
ASHA workers and ANMs for disseminating information regarding Aarogyam to target
was generated through films, songs, nukkad nataks
distribution of pamphlets, display hoardings and such like to disseminate information about
VALUATION
In order to monitor the proper functioning of Aarogyam system, regular
held with key stakeholders to assess the progress. Aarogyam also automatically generates
pending lists with respect to unfulfilled targets for medical officers, ANM
beneficiaries. Based on this list, call alerts and SMSs are sent to all stakeholders every 10 days
till the services are reported as delivered by the system.
reflects real time data on total number of grievances disposed,
pending in various offices, status of call alerts and SMSs sent on daily basis etc. This
information is regularly accessed by key officials including the CMO and District Magistrate
(DM) who then ensure that any visible gaps in health service delivery are attended to.
The Aarogyam software has the following components:
Management Information System (MIS) where health related data is uploaded and which
facilitates web based monitoring.
Interactive Voice Recording system (IVRS) and SMS service for sending automatic
reminder alerts and responding to help line queries and grievances.
Aarogyam utilises the existing hardware at the PHC, CHC and CMO office. The computers at
these offices are employed for use of the Aarogyam software.
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
8
es can also lodge specific health related complaints using the dial-in facility. These
complaints are registered on the Aarogyam MIS and then attended to by in-charge health
GENERATION
orientation of required officials at
district and block level was done so as to streamline the data capturing, consolidation and
reporting processes. Standardisation of required formats, periodicity of reporting, roles and
responsibility of the field workers and accountability of health officials were also fixed.
The district administration held several rounds of training workshops for village pradhans,
ogyam to target
(street plays),
distribution of pamphlets, display hoardings and such like to disseminate information about
In order to monitor the proper functioning of Aarogyam system, regular monthly meetings are
held with key stakeholders to assess the progress. Aarogyam also automatically generates
pending lists with respect to unfulfilled targets for medical officers, ANMs, pradhans and
beneficiaries. Based on this list, call alerts and SMSs are sent to all stakeholders every 10 days
reflects real time data on total number of grievances disposed, complaints
pending in various offices, status of call alerts and SMSs sent on daily basis etc. This
information is regularly accessed by key officials including the CMO and District Magistrate
elivery are attended to.
Management Information System (MIS) where health related data is uploaded and which
(IVRS) and SMS service for sending automatic
Aarogyam utilises the existing hardware at the PHC, CHC and CMO office. The computers at
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
FUNDING
The funds for Aarogyam have been secured under the Janani Suraksha Yojana
NRHM. Beneficiaries are not charged a user fee under the programme. The major costs
incurred were in the process of developing the software which round out to an approximate
amount of four lakh rupees. The running and maintenance costs of t
as it utilizes existing human and infrastructural resources.
IMPACT
IMPROVING ACCOUNTABILITY AND RESPONSIBILI
Under Aarogyam, health related data of each individual in every household is captured and
aggregated on a common web platform for monitoring by concerned officers. This monitoring
provides a clear picture on status of health services , action taken by various departmen
involved and the rate of compliance by target population. Aarogyam has also streamlined
processes for service providers by making available for them a comprehensive database that
MATERNAL AND CHILD
RELATED DATA COLLECT
AGGREGATION OF DATA A
AUTOMATED REMINDER ALERTS
SENT TO BENEFICIARIES AND HEALTH
SERVICE PROVIDERS ABOUT PENDING
APPOINTMENTS THROUGH IVRS
TECHNOLOGY.
DATA SUBMISSION AND ENTRY INTO THE
FIGURE 1: DIAGRAM SHOWING THE W
SOURCE: ONEWORLD
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
The funds for Aarogyam have been secured under the Janani Suraksha Yojana
NRHM. Beneficiaries are not charged a user fee under the programme. The major costs
incurred were in the process of developing the software which round out to an approximate
amount of four lakh rupees. The running and maintenance costs of the programme are minimal
as it utilizes existing human and infrastructural resources.
ITY AND RESPONSIBILITY OF HEALTH SERVICE
, health related data of each individual in every household is captured and
aggregated on a common web platform for monitoring by concerned officers. This monitoring
provides a clear picture on status of health services , action taken by various departmen
involved and the rate of compliance by target population. Aarogyam has also streamlined
processes for service providers by making available for them a comprehensive database that
ATERNAL AND CHILD HEALTH
RELATED DATA COLLECTION AT THE
.
GGREGATION OF DATA AT THE BLOCK LEVEL.
WEB-BASED PORTAL FOR
MONITORING OF HEALTH
RELATED SERVICE DELI
BE USED BY SERVICE
PROVIDERS.
HELPLINE FOR BENEFICIARIES
TO ADDRESS QUERIES AND
REDRESS GRIEVANCES.
NTRY INTO THE AAROGYAM SOFTWARE AT THE DISTRICT LEVEL
IAGRAM SHOWING THE WORK FLOW OF AAROGYAM
ORLD FOUNDATION INDIA
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
9
The funds for Aarogyam have been secured under the Janani Suraksha Yojana scheme of the
NRHM. Beneficiaries are not charged a user fee under the programme. The major costs
incurred were in the process of developing the software which round out to an approximate
he programme are minimal
TY OF HEALTH SERVICE PROVIDERS
, health related data of each individual in every household is captured and
aggregated on a common web platform for monitoring by concerned officers. This monitoring
provides a clear picture on status of health services , action taken by various departments
involved and the rate of compliance by target population. Aarogyam has also streamlined
processes for service providers by making available for them a comprehensive database that
BASED PORTAL FOR
MONITORING OF HEALTH
RELATED SERVICE DELIVERY TO
BE USED BY SERVICE
.
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
helps them prioritise their work commitments as well as address gap areas.
and calls to service providers have resulted in more accountability and also ensured better and
timely service delivery to the community.
The Aarogyam system has facilitated integration and effective participation of stakeholders at
various levels such as ANMs, AWWs ASHAs, teachers and village
health services and provides basis for rewards and incentives to well performing employees.
EMPOWERING THE COMMUN
Under Aarogyam, the economically and socially impoveri
information about medical services they are entitled to as per their health profile, demand
services related to ANC, PNC and immunisations that was earlier denied to them and was the
privilege of a select few. With A
various types of health services available to them and are also able to report any non
compliance to the health and district administration. This sort of community feedback is
providing valuable insight to the service providers regarding areas that need improvement.
BETTERING THE MATERNA
With Aarogyam, there has been an improvement in the measurable health indicators in the
state. Immunisation coverage particularly that
trend over time. The coverage of Polio, BCG, Measles and Tetanus coverage has gone up from
an average of 60 per cent in February 2008 to 91 per cent in February 2010.
institutional deliveries in the targeted districts has also risen.
The Aarogyam database has resulted in better planning of community level health programmes
especially with regard to ANC, PNC checkups and immunisation drives. Health officials are
now adequately informed about expected number of beneficiaries and can plan their activities
and use of resources accordingly. This helps in avoiding wastage of medical and human
resources. The model has also helped the Health Department to refocus its strategy on
preventive healthcare whereby on the basis of the health indicators reported and demand
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
helps them prioritise their work commitments as well as address gap areas.
and calls to service providers have resulted in more accountability and also ensured better and
timely service delivery to the community.
The Aarogyam system has facilitated integration and effective participation of stakeholders at
us levels such as ANMs, AWWs ASHAs, teachers and village pradhans
health services and provides basis for rewards and incentives to well performing employees.
MPOWERING THE COMMUNITY
conomically and socially impoverished and illiterate families can avail
information about medical services they are entitled to as per their health profile, demand
services related to ANC, PNC and immunisations that was earlier denied to them and was the
privilege of a select few. With Aarogyam, the beneficiaries have been able to understand the
various types of health services available to them and are also able to report any non
compliance to the health and district administration. This sort of community feedback is
nsight to the service providers regarding areas that need improvement.
ETTERING THE MATERNAL AND CHILD HEALTH SCENARIO IN U.P
With Aarogyam, there has been an improvement in the measurable health indicators in the
coverage particularly that of children has shown a significant positive
The coverage of Polio, BCG, Measles and Tetanus coverage has gone up from
an average of 60 per cent in February 2008 to 91 per cent in February 2010.
nal deliveries in the targeted districts has also risen.
The Aarogyam database has resulted in better planning of community level health programmes
especially with regard to ANC, PNC checkups and immunisation drives. Health officials are
ormed about expected number of beneficiaries and can plan their activities
and use of resources accordingly. This helps in avoiding wastage of medical and human
The model has also helped the Health Department to refocus its strategy on
e healthcare whereby on the basis of the health indicators reported and demand
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
10
helps them prioritise their work commitments as well as address gap areas. Instant messages
and calls to service providers have resulted in more accountability and also ensured better and
The Aarogyam system has facilitated integration and effective participation of stakeholders at
pradhans in the delivery of
health services and provides basis for rewards and incentives to well performing employees.
shed and illiterate families can avail
information about medical services they are entitled to as per their health profile, demand
services related to ANC, PNC and immunisations that was earlier denied to them and was the
have been able to understand the
various types of health services available to them and are also able to report any non-
compliance to the health and district administration. This sort of community feedback is
nsight to the service providers regarding areas that need improvement.
U.P
With Aarogyam, there has been an improvement in the measurable health indicators in the
has shown a significant positive
The coverage of Polio, BCG, Measles and Tetanus coverage has gone up from
an average of 60 per cent in February 2008 to 91 per cent in February 2010.6 The number of
The Aarogyam database has resulted in better planning of community level health programmes
especially with regard to ANC, PNC checkups and immunisation drives. Health officials are
ormed about expected number of beneficiaries and can plan their activities
and use of resources accordingly. This helps in avoiding wastage of medical and human
The model has also helped the Health Department to refocus its strategy on
e healthcare whereby on the basis of the health indicators reported and demand
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
generated, along with the complaints lodged in long term, precautionary measures can be
timely planned and implemented.
Aarogyam has benefited more than 1.4 lakh families up to
of operation in U.P., namely Baghpat, JP Nagar and GB Nagar. With its expansion to five other
districts, it is expected to benefit about 2 lakh people more. As of July, 2011 more than 175,000
automated calls and SMSs have been sent by the system.
PROVIDING A REPLICABLE MODEL FOR IMPROVIN
Since its development in 2008, Aarogyam has improved not just the RCH delivery processes in
U.P but also impacted RCH processes across the country.
Given its remarkable performance, Aarogyam has received several awards and recognitions
like the NASSCOM Social Innovation Honors 2010 and the M
made it amongst the finalist in the run up for prestigious awards like the St
and Manthan Award.
The Aarogyam model went on to become an inspiration behind the implementation of the
Mother and Child Tracking Programme (MCTP) under the NRHM by providing a
model to other Indian states for
CHALLENGES IN IMPLEMENTATION Restricted administrative capacity
The regular filing and submitting of data updates to the system at the block office is a time
consuming mechanism and has added additional work lo
rectified by dividing the work responsibilities between ASHAs, AWWs and ANMs.
Lack of a culture of transparency in government operations
It was a very challenging task to motivate health professionals and village
Aarogyam because it meant increased work load for them as well as tight monitoring of their
functioning. However, with time the efficiency and usefulness of the system was successfully
advocated to them and their cooperation secured.
Low motivation among community members
Getting the community on board was another significant challenge. Often the alerts sent out
from Aarogyam were mistaken as promotional calls. Gradually, with time, the community has
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
generated, along with the complaints lodged in long term, precautionary measures can be
timely planned and implemented.
Aarogyam has benefited more than 1.4 lakh families up to December 2010 in the three districts
of operation in U.P., namely Baghpat, JP Nagar and GB Nagar. With its expansion to five other
districts, it is expected to benefit about 2 lakh people more. As of July, 2011 more than 175,000
ave been sent by the system.
E MODEL FOR IMPROVING DELIVERY OF HEALTH
Since its development in 2008, Aarogyam has improved not just the RCH delivery processes in
impacted RCH processes across the country.
Given its remarkable performance, Aarogyam has received several awards and recognitions
like the NASSCOM Social Innovation Honors 2010 and the M-Billionth Award 2010. It has also
made it amongst the finalist in the run up for prestigious awards like the St
The Aarogyam model went on to become an inspiration behind the implementation of the
Mother and Child Tracking Programme (MCTP) under the NRHM by providing a
model to other Indian states for monitoring the delivery of maternal and child health services.
MPLEMENTATION Restricted administrative capacity
The regular filing and submitting of data updates to the system at the block office is a time
consuming mechanism and has added additional work load on the ANMs. This could be
rectified by dividing the work responsibilities between ASHAs, AWWs and ANMs.
Lack of a culture of transparency in government operations
It was a very challenging task to motivate health professionals and village
Aarogyam because it meant increased work load for them as well as tight monitoring of their
functioning. However, with time the efficiency and usefulness of the system was successfully
advocated to them and their cooperation secured.
ion among community members
Getting the community on board was another significant challenge. Often the alerts sent out
from Aarogyam were mistaken as promotional calls. Gradually, with time, the community has
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
11
generated, along with the complaints lodged in long term, precautionary measures can be
December 2010 in the three districts
of operation in U.P., namely Baghpat, JP Nagar and GB Nagar. With its expansion to five other
districts, it is expected to benefit about 2 lakh people more. As of July, 2011 more than 175,000
G DELIVERY OF HEALTH SERVICES
Since its development in 2008, Aarogyam has improved not just the RCH delivery processes in
Given its remarkable performance, Aarogyam has received several awards and recognitions
Billionth Award 2010. It has also
made it amongst the finalist in the run up for prestigious awards like the Stockholm Challenge
The Aarogyam model went on to become an inspiration behind the implementation of the
Mother and Child Tracking Programme (MCTP) under the NRHM by providing a workable
very of maternal and child health services.
The regular filing and submitting of data updates to the system at the block office is a time
ad on the ANMs. This could be
rectified by dividing the work responsibilities between ASHAs, AWWs and ANMs.
It was a very challenging task to motivate health professionals and village pradhans to support
Aarogyam because it meant increased work load for them as well as tight monitoring of their
functioning. However, with time the efficiency and usefulness of the system was successfully
Getting the community on board was another significant challenge. Often the alerts sent out
from Aarogyam were mistaken as promotional calls. Gradually, with time, the community has
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
been made aware about Aarogyam and the benefit
community has become more forthcoming.
Technological challenges
Aarogyam relies on telephonic communication to alert beneficiaries and government officials of
health services due as well as to enable users to enqui
services available. Therefore, in case of change in mobile numbers of stakeholders, the entire
database needs updation in order to continue functioning effectively. In many instances,
Aarogyam struggles to meet the des
beneficiaries) change their mobiles numbers unreported. Along with this, constant data
upgrading remains a tedious task and for this purpose ANMs have to be given adequate
incentives so that they perform
CONCLUSION While the Aarogyam team has already sent a proposal to the Government of Uttar Pradesh for
replicating the programme in the entire state, teams from various state and central
governments have met with them to learn from and adapt their model. The success of
Aarogyam lies in its ability to develop a responsive healthcare model. Its sustainability now
rests on the institutional will to leverage its potential in reforming rural healthcare scenario an
utilising the data it provides for scanning other health indicators and promoting various health
related campaigns. At the same time, it has to be ensured that Aarogyam continues to capture
the health needs of beneficiaries over time adequately and is ab
service providers.
Research was carried out by OneWorld Foundation India (OWFI), Governance Knowledge Centre (GKC) team.
Documentation was created by Research Associate,
For further information, please contact
REFERENCES
‘Aarogyam kendras: Technology11. 2010. Web. April 24. 2012. <
technologybased-healthcare-delivery
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
been made aware about Aarogyam and the benefits it provides them with As a result, the
community has become more forthcoming.
Aarogyam relies on telephonic communication to alert beneficiaries and government officials of
health services due as well as to enable users to enquire about various diseases and medical
services available. Therefore, in case of change in mobile numbers of stakeholders, the entire
database needs updation in order to continue functioning effectively. In many instances,
Aarogyam struggles to meet the desired output if the key stakeholders (officials and
beneficiaries) change their mobiles numbers unreported. Along with this, constant data
upgrading remains a tedious task and for this purpose ANMs have to be given adequate
incentives so that they perform this task with commitment.
While the Aarogyam team has already sent a proposal to the Government of Uttar Pradesh for
replicating the programme in the entire state, teams from various state and central
with them to learn from and adapt their model. The success of
Aarogyam lies in its ability to develop a responsive healthcare model. Its sustainability now
rests on the institutional will to leverage its potential in reforming rural healthcare scenario an
utilising the data it provides for scanning other health indicators and promoting various health
related campaigns. At the same time, it has to be ensured that Aarogyam continues to capture
the health needs of beneficiaries over time adequately and is able to communicate this to
Research was carried out by OneWorld Foundation India (OWFI), Governance Knowledge Centre (GKC) team.
Documentation was created by Research Associate, Sapna Kedia
For further information, please contact Rajiv Tikoo, Director, OWFI, at [email protected]
Aarogyam kendras: Technology-based healthcare delivery system’. The Indian Express
11. 2010. Web. April 24. 2012.
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
12
s it provides them with As a result, the
Aarogyam relies on telephonic communication to alert beneficiaries and government officials of
re about various diseases and medical
services available. Therefore, in case of change in mobile numbers of stakeholders, the entire
database needs updation in order to continue functioning effectively. In many instances,
ired output if the key stakeholders (officials and
beneficiaries) change their mobiles numbers unreported. Along with this, constant data
upgrading remains a tedious task and for this purpose ANMs have to be given adequate
While the Aarogyam team has already sent a proposal to the Government of Uttar Pradesh for
replicating the programme in the entire state, teams from various state and central
with them to learn from and adapt their model. The success of
Aarogyam lies in its ability to develop a responsive healthcare model. Its sustainability now
rests on the institutional will to leverage its potential in reforming rural healthcare scenario and
utilising the data it provides for scanning other health indicators and promoting various health
related campaigns. At the same time, it has to be ensured that Aarogyam continues to capture
le to communicate this to
Research was carried out by OneWorld Foundation India (OWFI), Governance Knowledge Centre (GKC) team. Sapna Kedia
The Indian Express. April
http://www.indianexpress.com/news/aarogyam-kendras-
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
‘Aarogyam ICT for mother and child care’. Information technology in developing countries.
July. 2011. Web. May 1. 2012 <
Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India.
Sample Registration Survey (SRS). July. 2011. Web. April 29. 2011. <
http://censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR_release_070711.pdf
Registrar General of India. Sample Registration Survey (SRS). SRS Bulletin. December. 2011.
Web. April 29. 2012
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
Aarogyam ICT for mother and child care’. Information technology in developing countries.
July. 2011. Web. May 1. 2012 < http://www.iimahd.ernet.in/egov/ifip/jul2011/ritu
Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India.
Sample Registration Survey (SRS). July. 2011. Web. April 29. 2011. <
http://censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR_release_070711.pdf
Registrar General of India. Sample Registration Survey (SRS). SRS Bulletin. December. 2011.
Web. April 29. 2012
http://censusindia.gov.in/Vital_Statistics/SRS_Bulletins/SRS%20Bulletin_%20December%20201
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
13
Aarogyam ICT for mother and child care’. Information technology in developing countries.
http://www.iimahd.ernet.in/egov/ifip/jul2011/ritu-mayur.htm/>
Maternal and Child Mortality Rates and Total Fertility Rates. Registrar General of India.
Sample Registration Survey (SRS). July. 2011. Web. April 29. 2011. <
http://censusindia.gov.in/vital_statistics/SRS_Bulletins/MMR_release_070711.pdf>
Registrar General of India. Sample Registration Survey (SRS). SRS Bulletin. December. 2011.
Web. April 29. 2012
http://censusindia.gov.in/Vital_Statistics/SRS_Bulletins/SRS%20Bulletin_%20December%20201
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
APPENDIX A – INTERVIEW BACKGROUND
1. Prior to the introduction of the ICT based initiative Aarogyam in 2008, what were the
problems in delivering the required heath care facilities (ANC, PNC and immunization) to
pregnant women and new born children in Baghpat and J.P. Nagar districts? How we
these problems being addressed?
2. Why was there a need to develop an ICT based maternal and child healthcare delivery
system? How do you think is this ICT system going to be an improvement over existing
mechanisms to provide and monitor health service d
3. Aarogyam seeks to address the problems of high Maternal Mortality Rate (MMR) and
Infant Mortality Rate (IMR) in the target districts. Was it introduced to further the
reproductive and child healthcare goals of NRHM? What are the spec
child health issues that Aarogyam seeks to address and how does it plan to do so?
PROGRAM DESIGN
STAKEHOLDERS
4. The key stakeholders in the project are National Informatics Centre (NIC),
Society-Baghpat and J.P. Nagar, P
ASHAs. What are their roles and responsibilities?
5. Are there any other stakeholders? If yes, please explain their roles and responsibilities.
PROCESS FLOW
6. As per our research, Aarogyam began with surveys
related health information in the districts and mapping their current health status.
a) Who was responsible for conducting these surveys? What was the unit of analysis for
these surveys?
b) Which health parameters do these surve
c) Who is responsible for aggregating the survey data? Where is it done?
d) How often are the surveys conducted?
7. On the basis of the data collected, health alerts are sent to beneficiaries and health service
providers about pending pregnancy a
calls. Who is responsible for sending these alerts? What is the format of these alerts? Are
they in the local language?
8. Beneficiaries can call a helpline for assistance with regard to their pregnancy and
immunization needs and for grievance redressal.
RANSPARENCY AND ACCOUNTABILITY
Governance Knowledge Centre Promoted by Department of Administrative Reforms and Public Grievances
Grievances and Pensions
Researched and documented by
OneWorld Foundation India
Aarogyam:
NTERVIEW QUESTIONNAIRE
Prior to the introduction of the ICT based initiative Aarogyam in 2008, what were the
problems in delivering the required heath care facilities (ANC, PNC and immunization) to
pregnant women and new born children in Baghpat and J.P. Nagar districts? How we
these problems being addressed?
Why was there a need to develop an ICT based maternal and child healthcare delivery
How do you think is this ICT system going to be an improvement over existing
mechanisms to provide and monitor health service delivery in the region?
Aarogyam seeks to address the problems of high Maternal Mortality Rate (MMR) and
Infant Mortality Rate (IMR) in the target districts. Was it introduced to further the
reproductive and child healthcare goals of NRHM? What are the spec
child health issues that Aarogyam seeks to address and how does it plan to do so?
The key stakeholders in the project are National Informatics Centre (NIC),
Baghpat and J.P. Nagar, PHCs, CHCs and rural health workers like ANMs and
. What are their roles and responsibilities?
Are there any other stakeholders? If yes, please explain their roles and responsibilities.
As per our research, Aarogyam began with surveys for collecting maternal and child
related health information in the districts and mapping their current health status.
Who was responsible for conducting these surveys? What was the unit of analysis for
Which health parameters do these surveys aim to measure?
Who is responsible for aggregating the survey data? Where is it done?
How often are the surveys conducted?
On the basis of the data collected, health alerts are sent to beneficiaries and health service
providers about pending pregnancy and immunization issues through SMS and phone
calls. Who is responsible for sending these alerts? What is the format of these alerts? Are
they in the local language?
Beneficiaries can call a helpline for assistance with regard to their pregnancy and
ation needs and for grievance redressal.
CCOUNTABILITY
Case Study Health
Digital Health Mapping and
Service Delivery
April 2012
14
Prior to the introduction of the ICT based initiative Aarogyam in 2008, what were the
problems in delivering the required heath care facilities (ANC, PNC and immunization) to
pregnant women and new born children in Baghpat and J.P. Nagar districts? How were
Why was there a need to develop an ICT based maternal and child healthcare delivery
How do you think is this ICT system going to be an improvement over existing
elivery in the region?
Aarogyam seeks to address the problems of high Maternal Mortality Rate (MMR) and
Infant Mortality Rate (IMR) in the target districts. Was it introduced to further the
reproductive and child healthcare goals of NRHM? What are the specific maternal and
child health issues that Aarogyam seeks to address and how does it plan to do so?
The key stakeholders in the project are National Informatics Centre (NIC), District health
HCs, CHCs and rural health workers like ANMs and
Are there any other stakeholders? If yes, please explain their roles and responsibilities.
for collecting maternal and child
related health information in the districts and mapping their current health status.
Who was responsible for conducting these surveys? What was the unit of analysis for
Who is responsible for aggregating the survey data? Where is it done?
On the basis of the data collected, health alerts are sent to beneficiaries and health service
nd immunization issues through SMS and phone
calls. Who is responsible for sending these alerts? What is the format of these alerts? Are
Beneficiaries can call a helpline for assistance with regard to their pregnancy and
TRANSPARENCY AND
Governance Knowledge CentrePromoted by Department of Administrative Reforms and Public Grievances
Ministry of Personnel, Public Grievances and Pensions
Government of India
a) How are these helplines managed? Were staff members specifically recruited for this
purpose?
b) Who responds to the grievances? Is a record of the grievances maintained?
c) What are the charges that accrue to callers for this service?
AWARENESS GENERATION AND
9. How was awareness generated among beneficiaries about Aarogyam and the purpose it
serves? How did beneficiaries respond to this new ICT based system
10. How was the support of service providers sought? Was there any resistance on their part?
If yes, how was it overcome?
11. Were service providers given any training for using and maintaining Aarogyam? Is yes,
please provide details of the