The central goal of Alliance for Saving Mothers and Newborns (ASMAN) initiative is to reduce neonatal and maternal mortality through an innovative facility-based intervention that enables healthcare workers to provide quality care during child-birth, writes Dr Bulbul Sood, Country Director, Jhpiego, in conversation with Elets News Network (ENN).

The premise of the ASMAN program is that most maternal and neonatal mortality is centred around delivery (intra and the immediate postpartum period).

For example, 27% of maternal mortality is due to haemorrhage, 11% sepsis and 9% obstructed labour. 34% of neonatal death is due to infection and 19% due to birth asphyxia. Thus, by focusing on building healthcare workers capacity to provide quality of care, supported by high-impact innovations, during the intra and postpartum period, ASMAN is likely to have a significant impact on the direct causes of maternal and neonatal mortality.

On April 30, 2015, the Government of India launched Dakshata “ a national-level initiative for empowering health workers for high quality care during childbirth. Jhpiego has been involved in this initiative since its inception. It has partnered with the Government to develop the programme design, learning resource package, and other programme tools. It is the lead technical partner for the implementation of this programme in high-focus states of the country, including Rajasthan.

Based on learnings from the implementation of Dakshata, in June 2017, Jhpiego decided to introduce technology as an additional driver for improved quality of care in labour rooms of public health facilities through ASMAN. 

ASMAN is an initiative for effectively driving the use of evidence-based best practices that reduce early maternal and newborn mortality by leveraging technology and is supported by a consortium of partners (Reliance Foundation, Tata Trusts, MSD for Mothers, Bill & Melinda Gates Foundation and USAID). e key stakeholders of this initiative are Governments of Rajasthan and Madhya Pradesh. is program is being piloted in four districts each of these two states, covering 39 and 42 facilities, respectively. Jhpiego is the lead implementing partner, Avalon Information Systems being the technology partner and Bodhi Foundation the gamification partner.

Digital intervention: ASMAN application is a tablet-based Intrapartum and Immediate Postpartum Monitoring and Decision Support Tool.

The ASMAN application is a useful tool for facility level implementing workers to state-level decision makers. This data-driven decision making tool, supported by targeted quality improvement activities, will help in achieving the goal of improved maternal and newborn health.

SALIENT COMPONENTS OF ASMAN APPLICATION ARE:

Case Management: Digitized case sheet (admission notes, e-partogram, delivery notes, post-delivery monitoring, postnatal care, discharge slip, referral slip, events section, safe childbirth checklist) with integrated clinical rules from admission till discharge.

Dashboard and reports: System generated dashboards and reports for respective health facility and aggregations of data at district and state level for managers.

E-learning content: All the Government of India modules, guidelines and tutorials in the form of audio, video, or readable content.

ASMAN Complication Management Game by Bodhi Foundation: Scenario based game on intrapartum and immediate postpartum complication management for developing critical thinking skills of health workers around safe child delivery.

Safe Delivery App by Maternity Foundation: Direct and instant access to evidence-based and up-to-date clinical guidelines on Basic Emergency Obstetric and Neonatal Care.

Remote Support Centre: 24 X 7 availability of obstetricians and senior nurses for remote support. The remote support centre will have access to all the cases registered into the system within a state. The health workers of various health facilities in need of assistance will contact the remote support centre as and when required.

Health Information System which generates reliable, and quality data is one of the key components of a strong and functional health system. is initiative will not only improve the way data is collected but also improve the ability of the system to interpret, analyze, translate and use the data.

We believe that ASMAN initiative will be a great leap towards improving decision making by service providers and the beginning of new dawn for informed data-driven decision making by the facility as well as district and state level officials. Jhpiego and alliance partners are looking forward to see the signicant benefits that improved data will bring to the overall healthcare system which will ultimately culminate in better maternal and newborn outcomes.

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