OVERVIEW OF REMIND CONTENT & APPLICATION

STRENGTHENING ASHA HOME VISITS FOR MATERNAL, NEWBORN AND CHILD SURVIVAL

UP-NRHM SITE VISIT TO REMIND

JULY 2013 – KAUSHAMBI DISTRICT

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PROJECT OVERVIEW

Reducing Maternal and Newborn Deaths (ReMiND) Pilot Project• Partners: CRS, Dimagi, Vatsalya

• Area of Intervention:

2 blocks of district Kaushambi District (Manjhanpur & Mooratganj)

• ASHAs covered: working with 255 by end May 2013

• Project Duration: 3 Years (Oct 2011 – Sept 2014)

• Donors: CRS’ Private Fund and USAID DIV 2.0 Fund

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COMMCARE – REMIND’S TECHNOLOGY PLATFORM

CommCare as a Job Aid for ASHA:

- Track and support woman through Pregnancy and Postpartum periods

- Track and support baby from birth through first 2 years of life

- Localized and designed for ASHA use

Combines audio and still images for counseling and assessment content based on ASHA Modules 2, 6 and 7

CommCare as a Reminder tool:- SMS reminders sent to ASHAs to remind of

upcoming visits and alert supervisor of missed visits

CommCare as a Decision Support tool:- Helps the ASHA identify Danger Signs and make the appropriate referral

SMS reminder to ASHA

ASHA Registers Pregnant Woman

ASHA Conducts Pregnancy Home Visits

Delivery

DANGER SIGN

DETECTED

Job Aid: assessment, counseling & data collection

Referral & Treatment in

Health Facility

PREGNANCY WORKFLOW

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SMS reminder to ASHA and missed visit alerts to supervisor

Postpartum Home Visits for Mother –

Days (0),3,7,14,21,28,42

End of Post-

Partum Period

DANGER SIGN

DETECTED

Job Aid: assessment, counseling & data collection

Home Treatment or Referral to

Facility

POSTPARTUM & NEWBORN WORKFLOW

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Newborn Home Visits for Baby –

Days (0),3,7,14,21,28,42

Mother’s Case Closed

Delivery

SMS reminder to ASHA

Infant tracked through Year 2

for Routine Immunizations

Infant Case Closed

Job Aid: assessment, counseling & data collection

YOUNG CHILD WORKFLOW (UP TO 2 YEARS OF AGE)

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End of Post-

Partum Period

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REMIND APPLICATION SUMMARY:

Five Modules to Guide the ASHA Workflow:1. Registration of Pregnant Mothers2. Management of Pregnant Mothers3. Management of Postpartum Mothers4. Management of Newborns & Young Children5. Referral Follow-Up

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- Pregnancy Checklist- Completion of ANC check-ups and Tetanus

Immunizations, Assess Use of Health Services, Assess High Risks Signs in Pregnancy

- Pregnancy Counseling- Information about High Risks and Pregnancy

Danger Signs, Antenatal Care, Nutrition, Rest and IFA, Pregnancy Danger Signs, Birth Planning and Preparedness, Essential Newborn Care

- Pregnancy Outcome- Delivery information, Pregnancy outcome,

Newborn and mother’s health after delivery

- Modify Pregnant Woman Info- Modify identification info for woman, and update

EDD/LMP information

PREGNANT MOTHERS:

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- Mother Postpartum Visit- HBNBC Mother Form

- Postpartum Counseling- Information about High Risks and Postpartum

Danger Signs

- High Risk Follow up*- Follow-up on high risks identified, Decision

support for assessing high risks

- Postpartum Review - Provides summary of information about status

and health of postpartum mother, high risks identified, and next scheduled home visit

- Close Postpartum- To be filled 42 days post delivery once

postpartum phase is complete

POSTPARTUM MOTHERS:

10*Note – currently undergoing field testing

- Home-based Newborn Care Visit- HBNBC Baby and CCSP forms

- Breastfeeding Assessment- Additional follow-up for any mother/newborn with

a suspected feeding problem.

- Routine Immunization Tracking through 2 years- BCG, OPV, DPT, Boosters, Polio, Measles, VitA

- Routine Immunization Counsel- Information about vaccines, benefits of

immunization, side effects, how/where to go

- Update Baby Info- Update any details about the newborn case

- Close Baby- To be filled to close the baby case after 2 years of

care and full immunization

YOUNG CHILD:

11*Note – currently under design

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SUMMARYThe ReMiND Pilot Project uses CommCare to:

- Provide a Job Tool for the ASHA to improve many aspects of her work, including:- counseling- timeliness of visits- tracking of mothers and children- identification of danger signs- following up with referrals

- Use the power of mobile phones to collect data on service utilization and key MNCH practices

- Collect data in Real Time that can be used by supervisors and project managers immediately

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SUMMARY OF BENEFITS

Improved Work Quality:

- Checklists improve performance

- Decision support increase adherence to protocols

- Validation and skip logic to improve quality of data

- Reminders to ASHAs of upcoming visits & referral follow-up

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THANKS

Assess Use of Health Services:Early registration with ANM, TT

Vaccination, ANC 1/2/3/4DANGER

SIGN DETECTED

FORM EXAMPLES: Pregnancy Checklist Form

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Immediate Referral

Assess Pregnancy Danger Signs

Assess Behaviors:IFA Consumption, increased nutrition,

proper rest, birth preparedness

Referral Follow-Up Form:ASHA provides update on client’s condition & referral status (complete/incomplete) 24 hours

after danger sign identified

SMS Reminder to

ASHA to Follow Up

Visit Status Labels:No. of days since delivery, no. of HBNBC home visits conducted to date, whether

current visit on time as per HBNBC schedule

FORM EXAMPLES: Postpartum Home Visit Form (HBNBC Mother Form)

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HBNBC Mother Assessment as per NRHM form

Home Management as per protocol

Referral Follow-Up Form:ASHA provides update on client’s condition & referral status (complete/incomplete) 24 hours

after danger sign identified

SMS Reminder to

ASHA to Follow Up

Immediate Referral as per Protocol

NEWBORN COMPLICATION

IDENTIFIED

SMS Reminder to

ASHA to Conduct Visit

SMS missed visit alert sent to ASHA supervisor if visit not completed on time

Visit Status Labels:No. of days since delivery, no. of HBNBC home visits conducted to date, whether

current visit on time as per HBNBC schedule

FORM EXAMPLES: Postpartum Home Visit Form (HBNBC Baby Form & CCSP Form)

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HBNBC form for baby

Home Management as per protocol

Referral Follow-Up Form:ASHA provides update on client’s condition & referral status (complete/incomplete) 24 hours

after danger sign identified

SMS Reminder to

ASHA to Follow Up

Immediate Referral as per Protocol

MATERNAL COMPLICATION

IDENTIFIED

SMS Reminder to

ASHA to Conduct Visit

SMS missed visit alert sent to ASHA supervisor if visit not completed on time

CCSP Form:If signs of infection or feeding problems

identified with HBNBC form