A new independent study has found that an innovative program, which uses a cell phone app to help pregnant women in India with prenatal and postnatal care, is as cost effective as certain immunizations and other proven child health interventions.
The app is part of Catholic Relief Services’ (CRS) Reducing Maternal and Newborn Deaths (ReMiND) project, which focuses on expectant mothers in Utter Pradesh, the most populous state in India and a place with high maternal and infant death rates.
ReMiND contributes to the Indian government’s National Health Program by equipping women who are trained as community health workers with the tools they need to gather and access information about their patients. To improve these health workers’ (also known as ASHA workers) effectiveness, ReMiND uses a mobile phone app that gives them crucial information, including a checklist of key health practices that they review with pregnant women during home visits.
Based on the checklist, ASHAs identify counseling topics relevant to a mother at her particular stage of pregnancy and health. Given the low literacy rates in Utter Pradesh, the app uses audio and visual tools to counsel the women. Data can then be downloaded by supervisors and government health officials to inform their health programs. ASHAs who use the cell phone app are performing better, and pregnant women are learning more about pregnancy and delivery, receiving more prenatal visits, taking more recommended nutritional supplements and getting more appropriate medical tests.
The new study led by principal researcher Dr. Shankar Prinja of PGIMER School of Public Health in Chandigarh, India, evaluated the impact of the ReMiND program and examined its cost effectiveness in achieving positive results. It found that implementing the program across the state of Uttar Pradesh over a 10-year period would result in significant health outcomes, including:
- A reduction of 16,918 maternal (16.4%) and 119,646 neonatal deaths (5.2%) during the 10-year period
- A 7.6% reduction in maternal illness during pregnancy
- 4.3% fewer cases of neonatal illness
- An increase in 2,290,857 life years
- A reduction of 3,971,317 Disability Adjusted Life Years (DALYs), a calculation of years of life lost from disease, or years lived with a disability
The study found that the ReMiND program would incur a cost of $96 per DALY averted, and $2,792 per death averted, making it as cost effective as Vitamin A and zinc fortification, measles immunization, pneumonia case management and oral rehydration therapy in the developing country context. Within India, the intervention was found to be as cost effective as measles and Hepatitis B vaccination and more cost effective than vaccines against cholera, typhoid and rotavirus.
The researchers concluded that the ReMiND approach and app could be considered not only by the National Health Mission in Uttar Pradesh, but also in national health systems.
“These findings are a remarkable testament to the ability of mobile technology to improve health outcomes in areas where access to health care is limited,” said Tony Castleman, CRS’ regional representative for South Asia. “We hope to leverage what we’ve learned to expand this type of programming in other parts of India and in other countries so this approach can improve the health of more women and children.”
Dr. Prinja presented his research on Mon., May 15, at the Information and Communications Technologies for Development (ICT4D) Conference taking place in Hyderabad, India, May 15-18. The conference brings together professionals from the public and private sectors to talk about how advances in technology can improve the way aid is delivered. His research will also appear in peer-reviewed academic journals later this year.
Copyright 2017 Nikki Gamer for Catholic Relief Services