BIHAR: A district magistrate revolutionises maternal care in north Bihar by adopting a digital app which was discarded at launch in Tamil Nadu as ‘unsuccessful.’ Rajesh Kumar Thakur finds out why the ‘failed’ app is working for expectant mothers in Mithilanchal
Shamim Akhtar, 36, had been plagued by the fear that his wife Shabana Parveen would die. Shamim would often wake up in the middle of the night, sweating, after having seen nightmares of ill-luck. Shabana had turned pale for some time now and she had been breathing heavily-almost wheezing. With no elderly women at home, he had feared for the worst. Shanti Devi, the village midwife had informed their neighbour, also expecting, that if she had mobile at home, she could download an app that would help her stay healthy at delivery time. Shamim gave it a try. Within hours of Shamim registering his wife’s condition, Shanti was home for a visit. Shabana, now in her tri-semester, was quickly identified for urgent care because of hypertension. That probably saved her life.
In a state like Bihar where skilled obstetric care is still a challenge, a digital health initiative through an app called ‘Wonder’ did the wonder for Shamim and Shabana, living in Darbhanga district. An initiative of District Magistrate Dr Thiyagarajan SM, it ensured ‘timely’ and ‘correct’ medical intervention and maternal care which saved two lives. Darbhanga now is the first district in India which has a system to maintain and monitor maternal care with the use of software developed by Narmadha Kuppuswami, an Illinois-based obstetrician and gynaecologist with more than 40 years of experience. Launched in August 2019, this wonderful app is being used at all Primary Health Centres (PHCs) and other hospitals of
Darbhanga by ANMs and other health personnel to monitor pregnant women’s health. It helps generate alerts over emerging complications among registered women and addresses problems with suggestions.
Thiyagarajan had heard about the app, first launched in Erode (Tamil Nadu) but discarded as ‘unsuccessful.’ He, however, was willing to give a ‘serious try’, he says. “It worked.”The electronic record system of the app uses special vital health signs in Red and Yellow colour as obstetrics warning signs, which helped a medical team to help Pinki Devi of Benipur, who registered through the app and was recently diagnosed with lack of haemoglobin. A health team visited her and provided vitamin and iron pills to overcome her seriously anaemic state. She survived too.
The DM said the facility has been provided to all PHCs in all 18 administrative blocks of the district after initial success in the first two blocks where it was tested. Thiyagarajan said at each block headquarter, the latest updates provided by ANMs and other health workers is fed. To begin with, over 21,000 pregnant women registered themselves by September 30, soon after it was launched. The numbers had crossed 70,000 by January 2020. Around 15,000 patients opted for HB test through the app while over 13,000 patients registered for HIV test too. Darbhanga being a district with heavy out-migration of men and huge caseload of HIV, the app has helped control future risks in women.
Senior health personnel, including doctors, have the app on their smartphones, while trained personnel monitor it on their desktops. Rekha Devi, ANM, posted at Benipur primary health centre, some 35 km north of Darbhanga, said, “The process of patient examination is recorded and can be transferred as a digital or paper file for hospital record, even as it helps remind a patient of when she should get admitted or come for check-ups. Even Chief Minister Nitish Kumar, appreciated the effort and said it would be recreated all over,” she said.Thiyagarajan too flaunts the app on his smartphone.“That’s for overall supervision,” he says with a smile.