Asara: Maternal Telehealthcare for Tribal Women

Asara(c) reduces maternal mortality through telemedicine technology, capacity building, dedicated health workers and community buy-in.

Sobre ti

Organización: Health Management and Research Institute más ↓↑ ocultar↑ ocultar

Sobre ti

Nombre

Balaji

Apellido

Utla

Sobre tu organización

Nombre de la organización

Health Management and Research Institute

Sitio web de la organización

País de la organización

India, AP, Hyderabad

Países en donde este proyecto está creando impacto social

India, AP, Araku Valley

Tu organización es

OSC/ONG

¿Cuánto tiempo ha estado operando la organización?

1-5 años

¿Tu organización ha recibido premios y/u honores? Cuéntanos sobre ellos.

• 2011 eWorld Forum, Jury Choice Award for “Best ICT Initiative in Improving Maternal Health”
• 2011 The World Education Summit, Jury Choice Award for “Best Public-Private Initiative in Vocational and Skills Training”
• 2011 NASSCOM and KPMG, Healthcare IT Awards, “Best Technology Solution for Healthcare Inclusion”
• 2010 EdelGive, Social Innovation Honors, “Health and Well Being”
• 2010 NASSCOM, Social Innovation Honors, “ICT-led Innovation by Non-profit Organizations”
• 2009 eIndia, eHealth Award, “Civil Society/Development Agency Initiative of the Year”
2009 Manthan South Asia Award, “Best eContent for Health Services

Referencias – Por favor provee dos referencias con una biografía de dos renglones y una dirección de e-mail para cada una.

Mr. P.K. Hota
E-mail: puruhota@yahoo.co.in
Mobile: +91 9818 567830

Mr. P.K. Hota is the former Secretary of Health and Family Welfare for the Government of India.

Sashikumar Maranganty
E-mail: sashi@yugantar.org.in
Mobile: +91 9848 533023

Sashikumar Maranganty is CEO of Yugantar, an NGO based in Hyderabad that works in the area of social equity. Mr. Maranganty is also a Member of HMRI’s General Body.

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Innovación

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Selecciona la fase que describa mejor el momento en el que se encuentra tu emprendimiento

Crecimiento (tu iniciativa piloto ya se está aplicando y se empieza a expandir)

¿Cuánto tiempo se lleva poniendo en práctica tu iniciativa?

Operando entre 1-5 años

¿Cuál de las siguientes describe mejor la(s) barrera(s)s a la que da respuesta tu innovación? Elige hasta dos.

Acceso, Costo.

La necesidad: ¿Cuál es el problema que tratas de solucionar?

Asara(c) works to address issues of accessibility, availability and affordability of maternal healthcare among remote tribal women in the hilly areas of Araku Valley, Andhra Pradesh. At 400 and 150, respectively, the maternal mortality ratio and infant mortality rate of this area is significantly higher than Andhra Pradesh and India. Much of this is due to lack of infrastructure, education, poverty and cultural beliefs. By integrating with the community, leveraging rural health workers and delivering healthcare to the doorsteps of the people, HMRI's Asara(c) program works to reduce maternal and infant mortality.

La solución: ¿Cuál es tu solución? Sé específico.

HMRI’s Asara(c) project envisions a future in which tribal women have access to high quality and affordable maternal healthcare, the ability to make informed decisions about their health, and do not die due to preventable or manageable causes. To achieve this goal, Asara(c) deploys a comprehensive solution to health that provides women with culturally grounded and medically validated health information through IEC activities, first level care through the training of traditional birth attendants, and virtual access to specialist physicians through videoconferencing. HMRI achieves this cost-efficient, high impact solution by leveraging cutting-edge information and communications technologies and superior operations management.

El Modelo: Muéstranos a través de un ejemplo específico cómo tu solución hace una diferencia, incluye tus actividades primarias

HMRI initiated Asara© not only in response to the region’s alarming maternal mortality ratio (MMR), but also to address maternal mortality’s root causes. These include a lack of education (Araku Valley’s female literacy rate is 22.70%, compared with 59.74% for the state), geographic and financial access to healthcare (Araku Valley faces poor road connectivity and families earn roughly $23/month), and skilled health workers.

The goal of Asara© is to reduce the region’s MMR. HMRI does this through conducting the following activities free of cost and through the use of innovative technology::

• Capacity Building. HMRI trains community health workers (CHWs) on maternal health and traditional birth attendants (TBAs) on safe delivery methods. HMRI also provides TBAs with delivery kits.
• IEC Activities. Trained CHWs train local communities on maternal health and facilitate behavioral change.
• Village Health Outreach. Trained ANMs travel to each habitation once per month to monitor pregnancies, conduct screenings, and refer patients to the telemedicine center.
• Telemedicine. HMRI’s vehicle transports pregnant women from a pickup point to the telemedicine center where they undergo a physical examination and lab tests, consult with an OB/GYN located in Hyderabad via videoconferencing, and receive medication/supplements if necessary.

Asara(c) uses Dox-in-Box(R), HMRI's unique point-of-care technology to capture patient vitals in the field, bridging gaps in distance and time and eliminating unnecessary trip to the telehealth center.

El mercado: ¿Quiénes son tus pares y competidores? Identifica a otros que también estén trabajando para dar respuesta a las necesidades que tú abordas y en qué te diferencias de ellos. ¿Cuáles son los desafíos que estos jugadores podrían representar para tu éxito o crecimiento?

Two organizations conducting similar work in India are SEARCH (Society for Action, Education, and Research in Community Health) and ARTH (Action, Research, and Training for Health).
Asara’s© approach is more comprehensive facing no challenges from other parties. ARTH does not solve the geographic barriers and specialty deliveries for high-risk pregnancies. SEARCH does not offer three antenatal checkups like Asara© does. Nor does it provide village-level screening services with the use of technology to ensure that women travel to the telemedicine center or hospital only if medically necessary. Asara© combines the village-level healthcare that SEARCH and ART strive for with the specialty services of urban OB/GYNs and the technological innovation of Dox-in-Box®.

Impacto social

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Historia de la fundación: Queremos saber acerca del momento en el que hiciste "¡Ajá!". Comparte la historia de dónde y cuándo el/los fundador(es) vio (vieron) el potencial de esta solución para cambiar el mundo.

Dr. Mastan Rao Govada founded Asara©. He has over 40 years of experience in medicine and public health and served as Director of Health, Andhra Pradesh.

Dr. Mastan Rao grew up as a member of a marginalized community. Throughout his youth he saw society’s inequality and disparity. Although he felt he was unable to effect change when he was young, Dr. Mastan Rao decided to commit himself to social service and became a doctor. He recalls, “Walking through [tribal] areas you can feel the smell of it [disparity].”

Once the issue of maternal mortality began to garner attention, Dr. Mastan Rao saw an opportunity to transform society through programmatic innovation. He pioneered HMRI’s Asara© program to solve the health inequalities he witnessed his entire life.

Por favor, describe el objetivo de tu iniciativa: un resumen de lo que están tratando de lograr

HMRI primarily aims to decrease maternal and infant mortality through preventative healthcare, early identification of high risk cases, education on hygiene and nutrition for mothers and infants and inculcating behavioral changes among the tribal population of India.

¿Cuál ha sido el impacto de la solución hasta la fecha?

The primary metric for Asara’s© success is the number of maternal and infant deaths. Pregnancy outcome is another key factor. Among Asara’s© 900 deliveries, there have been 816 live births, 11 stillbirths, 27 abortions, and 30 neonatal deaths. Two maternal deaths have been recorded, compared to 7 expected maternal deaths per the region’s MMR. Additionally, there has been an increase in institutional deliveries by 50%.

Another important factor is registrations. 2,155 beneficiaries have registered. The number of registrations during the first and second trimesters has risen from 11-30% and 36-48%. This demonstrates the less measurable yet equally important factor of changing perceptions of maternal health among tribal people.

Cuál es tu impacto proyectado para los próximos 5 años?

HMRI plans two key evolutions over the next five years. The first is that HMRI will reduce the maternal mortality ratio among tribal populations under its service areas by 50%. The second is that HMRI will add seven new telehealth centers throughout Paderu Division, Andhra Pradesh, to reach the target tribal population, roughly 5,600,000 and later to the other parts of India. The services would be rendered beyond maternal and infant care to include illnesses that debilitate tribal communities. These illnesses will include, but are not limited to, malaria, vector-borne diseases, anaemia, goiter, arthritis, and malnutrition, etc.

¿Qué barreras pueden dificultar el éxito de tu proyecto? ¿Cómo planean superarlas?

One major barrier to the success of Asara© is long term funding to run the project. MacArthur Foundation initially funded Asara© . In the long term, reliance on one source of funds is not sustainable. HMRI is actively pursuing government partnerships, wealthy individual donors and multilateral aid organizations in order to diversify its revenue stream.

Social barrier like myths and tribal customs prevalent in these tribal populations is the second hurdle that Asara© is striving to overcome. By working closely with CHWs and TBAs and conducting village outreach, Asara© staff have been able to develop relationships and build trust with communities.

Las iniciativas ganadoras presentan un plan fuerte de cómo van a alcanzar y realizar un seguimiento del crecimiento. Identifica tus metas a seis meses para el crecimiento de tu impacto

HMRI aims to change the behavior of pregnant women so that they actively seek healthcare.

Identifica tres grandes tareas que tendrás que completar para llegar a las metas de seis meses.

Tarea 1

Train health workers to identify neonatal risks and motivate parents to bring their infants to the hospital if necessary.

Tarea 2

Form committees to oversee risky cases on a weekly basis to ensure they do not degenerate into morbidity/mortality.

Tarea 3

Ensure key village influencers become aware of pregnancy/neonatal risks and become part of the change process.

¡Ahora piensa en grande! Identifica tu meta de impacto a 12 meses.

Ensure that no deliveries will occur without the presence of a doctor or trained traditional birth attendant.

Identifica tres grandes tareas que tendrás que completar para llegar a tu meta de impacto a 12 meses

Tarea 1

Train and conduct refresher trainings for all traditional birth attendants (TBAs) in the project area.

Tarea 2

Establish early risk identification and management program so that pregnant women and TBAs can take necessary precautions.

Tarea 3

Establish a referral system so that pregnant women can go to gov't hospitals with Asara(c) records and undergo care immediately.

Sostenibilidad

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Cuéntanos sobre tus alianzas.

HMRI partners with MacArthur Foundation, Centre for Policy Research, Avantor Performance Materials, and Zolt Info Solutions for Asara© . Centre for Policy Research conducts independent, third party monitoring and evaluation. Avantor Performance Materials supplies laboratory equipment and SEDY – 12 and ER – 2007. HMRI purchases Chem master – Semi Automated Biochemistry Analyser and Noble III which are integrated with HMRI’s telemedicine software. HMRI works closely with Zolt Info Solutions to develop HMRI’s patient service software and Dox-in-Box®.

¿Actualmente te estás dirigiendo a otras poblaciones, lugares o los mercados para tu innovación? Si es así, ¿dónde y por qué?

HMRI plans to initially expand Asara© through the addition of seven maternal telehealth centers throughout Paderu Division, Andhra Pradesh, serving a tribal population of 600,000. Later we plan to scale up the project to the entire tribal population of Andhra Pradesh, which comprises five districts of the state. Once these centers are established HMRI plans to expand to tribal areas throughout India.

¿Qué tipo de sistema operativo y factores internos de la organización hacen que tu innovación sea un éxito?

HMRI possess a strong operational team with visionary leaders directing the project towards its goals. However, its our on-the-ground relationships that make Asara© so successful. Our dedicated field staff have cultivated community buy-in which is evident from increasing registrations. Our managerial team maintains close connection with the staff and on-the-ground program workings to provide a constant atmosphere of support. The managerial team also looks out for the big picture, looking for ways to improve and expand the program.

Por favor, pon en claro las necesidades u ofertas que hayas mencionado anteriormente y/o sugiere categorías de apoyo que no están especificadas en la lista

HMRI anticipates collaborating with organizations that would aid in delivering high quality, low cost, technology-enabled healthcare to rural populations.

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