remind pilot project - strengthening asha performance through improved supervision
DESCRIPTION
Catholic Relief Services partners with Dimagi Inc. and Vatsalya to implement the Reducing Maternal and Newborn Deaths (ReMiND) Pilot Project in 2 blocks of Kaushambi District in Uttar Pradesh (India). ReMiND has pioneered a supervision approach that uses Dimagi's CommCare technology and active use of real-time data generated from community health workers' and supervisors' use of mobile phones to improve the quality and timeliness of government community health workers' (called ASHAs) home visits to pregnant women, newborns and young children.TRANSCRIPT
SUPPORTIVE SUPERVISION & MONITORING
USING DATA TO IMPROVE ASHA PERFORMANCE & MONITOR HEALTH OUTCOMES
UP-NRHM SITE VISIT TO REMIND
JULY 2013 – KAUSHAMBI DISTRICT
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SUPPORTIVE SUPERVISION & MONITORING
Analysis & use of
ASHAs’ real-time
data
Outcome:Maternal, newborn & child health outcomes
CommCare HQ
Supportive Supervision Application
Quality:IPC & counseling
skills, Mobile skills
Analysis & use of real-
time supervision
data
Active Data Management
Reports
Output: Frequency & timeliness of ASHA home visits
SMS reminders & missed visit alerts
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SAMPLE ADM REPORT
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SAMPLE ADM REPORT
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*DeRenzi et al. (2012a) Improving Community Health Worker Performance Through Automated SMS.
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SUPPORTIVE SUPERVISION APP
ASHA Registration
Form
ASHA Follow-up Form
Home Visit Observation
Form
Mobile Experience
Survey
Technology Issue Form
Tech Issue Follow-up
Form
Meeting Form
CommCare HQ – Cloud-based server
All dat
a up
loade
d &
acce
ssibl
e in
real-
time
ASHA encouraged woman to use next health service
ASHA waited for client to respond before moving on
ASHA expanded on ICT audio message
Client asked any questions
ASHA encouraged client to speak or ask questions
ASHA greeted woman
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
76%
78%
91%
61%
79%
98%
50%
59%
59%
24%
58%
85%
Trends in quality of ASHA home visitsSep-12 Mar-13
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HEALTH OUTPUTS & OUTCOMESIndicator (Data) Jan – March
2013
Number of new pregnancy cases registered in CommCare in quarter
1,084
Total number pregnant women tracked with CommCare in quarter
2,286
Total number pregnancy cases closed during the quarter 918
% CommCare clients who were registered with ANM before the fourth month of their pregnancy
79.8%
% CommCare clients giving birth at a health facility 74.4%
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PERFORMANCE FEEDBACK RESEARCH
Conducting study with Harvard Business School and University of Washington on the effect of personalized feedback graphs provided to the ASHAs on their Performance
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SUMMARY OF BENEFITSImproved Accountability:- Real time monitoring of daily activity of each ASHA
- Active Data Management gives key information to Supervisors to improve workforce performance
- Notifications to Supervisors of missed visits
Improved Access to Information:- More timely data
Improved Experience- Improved credibility of ASHA
- Multimedia to improve usability for all workers
Scalability:- Supervision applications are transferrable to ASHA Facilitator cadre- The ReMiND intervention is scalable, given the ASHA
Facilitator/Supervisors are in place, motivated, and effective.
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THANKS
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SUPPORTIVE SUPERVISION & MONITORING