Project Director – Maternal and Newborn Health Project (Manthan Project), IntraHealth
Amod Kumar is an Indian Administrative Services officer of the 1995 batch, belonging to UP Cadre. He has held several positions in the UP government, some of which include, Special Secretary, Basic Education & Director, Mid-day-Meal; Special Secretary, Revenue and Special Secretary, IT. Currently, he is working in the capacity of Project Director, Maternal and Newborn Health Project (Manthan Project) at IntraHealth.
Pratap Vikram Singh, in conversation with Amod Kumar finds out details of the MNH project and the effective use of ICT in the projects that Amod has been associated with
Please elaborate on the work being done in the health sector in the state of Uttar Pradesh by IntraHealth?
Manthan Project is a US $4 million initiative funded by the Bill & Melinda Gates Foundation. It aims to improve the health of mothers and newborns in northern India. Compared to other Indian states, Uttar Pradesh has the highest percentage of maternal and neonatal deaths in India. With a duration of four years, this project will work with the Uttar Pradesh state government to identify proven, effective mother and neonatal health (MNH) interventions; advocate at district, state, and national levels to promote the adoption and scale-up of these interventions and expand healthcare services to more mothers and newborns.
Being one of the UN Millennium Development Goals, reduction in child mortality by two-thirds by 2015, the existing state of neonatal health is not encouraging worldwide. Reports suggest out of an estimated 130 million infants born each year worldwide, 4 million die in the first 28 days of life. Three-quarters of neonatal deaths occur in the first week, and more than one-quarter occur in the first 24 hours. Neonatal deaths account for 40 percent of deaths under the age of 5 years worldwide. Two-thirds of the world’s neonatal deaths occur in just 10 countries, mostly in Asia. Almost two third of the mortality, that is 67 percent, occurring in the infant group happens with neonatal category.
Speaking India centric, there are some critical managerial and administrative gaps in the way government has dealt with on these healthcare and nutritional issues, which have lead to the poor state of delivery of services. With intent to eliminate these gaps, the project objective is to put innovations in the plan itself so that it is completely functional, with the least error.
Another major focus is on to rope in the private sector in facilitating quality health care services. We would explore the adaptability and application of successful models like Chiranjeevi in Gujarat and Rashtriya Swasthya Bima Yojana (RSBY) at Central level. Similarly, Madhya Pradesh has got a successful model known as Janani, which has recently been evaluated by UNICEF and involves facility assessment.
How do you propose to use ICT for better delivery and monitoring of services?
We see ICT as a vital tool for efficient delivery of healthcare services. Although leveraging ICT is still at a conceptual stage, we would be using ICT in three-four ways. First is to reach to the ultimate client through SMS, educate them on remedies and initiate a behavioral change. We plan to direct IVRS calls, giving reminders about the precautions and timely intake of medicines. We also want to educate and remind the ASHA workers (the healthcare workers in the state) through the use of multimedia-smart phones, which are now available at much cheaper prices. We can store a video on educating the workers and aiding them in better counseling. Another agenda is to improve monitoring through generation of management information systems (MIS) reports. Through ICT, we can gather, de-duplicates and analyse the data in a better fashion, with an ultimate objective of use of data in planning. Fortunately, because of RSBY, we have the base line data. Since the work involves research, advocacy and aiding government in planning and decision making, we have not sketched figures for assessing project outcomes. The outcome could be gauged in the degree of receptiveness in the government and the subsequent efficiency and equity created at the grassroots level.
Can you throw light on the ICT systems deployed for monitoring of mid-day meal scheme in UP, while your association with the state Mid-Day Meal Authority?
During my association with the mid-day meal authority, we developed a system to monitor the mid day meal scheme with the help of cloud telephony. For its monitoring in all the 1.5 lakh schools in the state of Uttar Pradesh, the department gives IVRS calls to all the teachers through which the teachers are asked for the number of students who took meals on that particular day. Almost 1800 calls are made parallely. By evening the department gets data for all the schools.
Initially, the teachers are informed that the call is being made on behalf of the mid-day meal authority. It asks the teacher to punch in the number of students who were served the meal that day. If the teacher punches in zero, he is given four reasons and told to punch in the appropriate number. The reasons are: 1. Cook was absent; 2. Non-availability of raw material for cooking; 3. Transportation problems; and 4. Other reason. The responses are simultaneously recorded on the website of the mid-day meal authority. The BSAs can go to website, choose respective blocks/district and check the daily meal reports. All this is done in Hindi language. Now, the Union Ministry of Human Resource Development is deliberating on scaling up the monitoring project across all states and UTs.