Dr Arun Varma
Vice President & Head Health Initiatives, IL&FS Education Technology Service

IL&FS Education Technology Services (ETS) is the social infrastructure initiative of IL&FS India. Established in 1997, IL&FS ETS Ltd specialises in the fields of education, health initiatives, e-governance, financial inclusion, skill development, and industrial cluster development. By integrating the benefits of information and communication technologies and medicine, we offer innovative methods and technology to deliver healthcare services to the people in remotest regions of the country.We are the first private corporate to be nominated as principal recipient of the global fund to fight against HIV/AIDS, Tuberculosis and Malaria (GFATM) and to manage the Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) programme in the country.

What services are you offerings in the mHealth domain?

The Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) programmes objective is to counsel, test and treat pregnant women who are HIV positive so that the transmission of virus to the child can be prevented.  The process involved is generally manual where the field workers use paper forms, booklets and registers to record details of the service and treatment provided. The data is aggregated manually in most of the cases and uploaded to the computer software systems for the purposes of reporting and analysis.

Since the system is largely manual at the field level, the field workers find it very difficult to maintain proper records. Tracking and monitoring of the HIV positive women for the purposes of providing Antiretroviral Therapy (ART) or other treatment on time becomes difficult, thereby raising the risk of transmission.

One of the key factors for achieving a high success rate in this endeavour is to use an appropriate ICT enabled technology solution for tracking and monitoring HIV positive pregnant women for the purpose of counselling, testing and treatment as well as monitoring the new born babies for a period of up to 18 months post birth. In this context, we have introduced a mobile based monitoring system that addresses the monitoring and management system requirements of this programme.

Enlist the clients to whom you are providing your services. What model do you follow?  

At present the mobile phones with the PHMMS application are used by the field workers called outreach workers (ORWs) to track our primary clientele, pregnant women, mainly from poor socio economic background. In near future, we are planning to bring in more clients like healthcare workers in the communities such as Accredited Social Health Activists (ASHA) workers who can use a similar mobile based tracking system for various programmes.

The outreach workers are provided with a mobile phone installed with easy to use software to record their visit details to a HIV affected pregnant women or a HIV infected woman with a baby within 18 months. The data collected during the visit is securely transmitted to a central server. The mobile phone application prompts and reminds the outreach worker about the various HIV positive pregnant women in her care, for whom the next course of action like next Anteretroviral Therapy visit, CD4Test, due for delivery, baby follow up is due and such other important information. The outreach worker can easily track the beneficiary and provide the access to the required treatment or health service. The solution has a web application that can be accessed from any internet connected computer. The web application provides the reports, analysis and management control of the programme for various stakeholders, agencies and the government.

How have you seen the advancement in the field of mHealth in India over last decade?

mHealth is in very nascent stage in India. With the exponential increase in number of mobile phone users and the huge demand for healthcare services in our country, there is certainly a huge market potential for mHealth for tangibly mitigating some of the inherent problems in the healthcare service delivery in the country both in the public and private sector.

What are the innovations you are bringing into the market?

The programme is unique. It can be scaled globally to enable the tracking of HIV positive women through mobile phones. The model empowers outreach workers in using a software application for providing the grass root level data using the mobile phone as a medium. (In conversation with Dhirendra Pratap Singh)