Principles for Design & Development

The ReMIND Project: Reducing Maternal and Newborn Deaths

This case study illustrates how CRS and its partners have been implementing the Principles for Digital Development since 2011 in The ReMiND Project in the Kaushambi district of Uttar Pradesh, India.


OVERVIEW

The ReMiND project was formed in April 2011 in response to poor health indicators in Uttar Pradesh (UP) and the unrealized potential of the ASHA (Accredited Social Health Activists) program.

  • The goal of the project is to contribute to increased and sustainable improvements in maternal, newborn and child survival (MNCH). It has the following objectives:
  • Increase ASHAs’ coverage (i.e., increase the number of pregnant women who are visited at least once by an ASHA).
  • Increase ASHAs’ frequency and quality of counselling to their pregnant clients.
  • Increase client knowledge of danger signs during and after pregnancy.
  • Increase the adoption of key maternal, newborn and child health and nutrition practices of clients during and after pregnancy (e.g. number of antenatal care visits, Tetanus Toxoid injections, care seeking for danger signs, and appropriate breastfeeding).

CONTENT


ReMiND has a number of key intersecting components that work together to strengthen community-level systems around maternal and newborn health:

  • The ASHA app: A phonebased counselling job aid to support the ASHA to mobilize the beneficiary to access health services.
  • The Sangini app: An app that helps the ASHA supervisor supervise and support the ASHA’s work, according to a 10indicator list.
  • Meeting platforms: Existing meeting platforms are reworked to ensure they are an opportunity for problem solving, support and learning. There are meetings for ASHAs, Sanginis and one for Block Health Education Officers.
  • A training program—to build interpersonal counselling skills and phone literacy.

ASHAs in the project use basic mobile phones operating Dimagi’s open-source CommCare software, which equips them with multi-media job aids to support client assessment, counseling, and early identification, treatment and/or rapid referral of pregnancy, postpartum and newborn complications, and tracking of childhood immunizations. The content was developed in consultation with partners, district and state government, ASHAs and the women they serve. Pregnant women are registered and tracked through pregnancy, delivery and the postpartum period with continued tracking newborns and young children through their second year of life. Once a birth is reported, SMS reminders repeatedly prompt the ASHA to conduct scheduled postpartum visits until that visit is recorded in the system. The system also alerts ASHA supervisors via SMS if ASHAs miss postpartum home visits.
The ReMiND project is featured in “mHealth Basics” course available on USAID’s Global Health eLearning Center: https://www.globalhealthlearning.org/course/mhealth

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