There are over 330 CHWs who are trained and strategically deployed across six states in rural India and have been rendering services under iKure’shealthcare delivery system.

Jayashree is one the CHW who works relentlessly in her village Hubli(Karnataka). One day, she visited a woman named Pushpa who was in her first trimester and looked quite unwell.On enquiring, Pushpa was found to suffer from Epilepsy. Her family also revealed that she has been prescribed with medicines by a local doctor, but she didn’t take them regularly.

Epilepsy is a disorder of the nervous system and such patients during pregnancy have major concerns. Jayashree felt the need and promptly captured her vitals on her smartphone loaded with Wireless Health Incident Monitoring Systems, (WHIMS), and pushed the patient’s vitals on to the cloud for a quick doctor reference.

For the next few days, Jayashree monitored and screened her closely and counselled her and family about different preventive measures pertaining to her health conditions. Soon after, Pushpa recovered and gave birth to a healthy child.

In the context of rural settings, it is never possible to create doctors or health clinics as required. To bridge the gap, the grassroots community members are empowered to provide clinical careenabled through WHIMS.The technology application is designed with an intuitive graphics user interface that can be efficiently used by a health worker even with a basic education.

For instance, WHIMS screen has a complete photograph of a human body.When a health worker clicks on the head, WHIMS gives options of potential symptoms of the head, such as ache, dizziness, seeing dark spots, and so on.

Usually with the standard diagnostic tool, low accessibility and portability remain a huge constrain. WHIMS is accompanied with low-cost portable instruments to measure basic statistics and loaded on a tablet is carried by the CHWs in the remotest villages to diagnose patients. The patients pay an affordable rate for basic diagnostics and consultations, through which they earn additional income.

Unlike the Accredited Social Health Activists (ASHA workers) who work as community mobilizer and not authorized to deliver clinical services, these CHWs meet both the ends.

Equipped with a medical kit that consists of devices including BP machine, stethoscope, pulse oximeter, thermometer, first aid kit, weight machine, Height measuring scale and gloves,they carry medicines for basic common ailments, non-invasive hemoglobin meter, haemoglobin kit, mobile phone based sphygmomanometer, urine analyzer, calorimeter, ECG, flipcharts/ Hoardings & registers.

Through these CHWs, every patient is also provisioned with Digital Health Card (DTH) encrypted with a QR (Quick Response) code and during home visits. DTH gets updated with latest clinical indicators. The health data obtained from the health cards is synced to a cloud for effective utilization in the upward heath chain at both secondary and tertiary levels.

CHW’s contact and familiarity within the community drive effective community mobilization measures. As they become an integral part of the healthcare delivery model, CHWs act as a catalyst to drive behavioral change. While they interacts and communicates the necessity on the ground and identifies appropriate health needs, it is through street plays, hoardings and message dissemination on mobile phones, theymobilize patients at different levels. They are also attuned to provide nutritional counselling, and spectacle services based on the community needs.

Further, WHIMS is upgraded with robust supply chain management framework, innovative algorithm, and Data Warehousing solutions. Driven by its CHWs, iKure aims to bring efficiency in public system & programe and improve lives.

The CHW model of empowering the women community and gender mainstreaming represents transformational change in rural healthcare delivery. As they champion tech-savvy cultural values in otherwise austere facilities, and limited supply of doctors, such effort has established inspirational leaders driving catalyst change in sustainable rural development.

“For a basic diagnostic long distance travel time, high cost of services and prolonged waiting hours at the local PHCs was a huge burden for these rural residents. Use of P-O-C devices is extremely portable, affordable with high accuracy rate and can be used by any health worker with a short training. This has been a critical step in rural healthcare delivery with a positive outcome on prevention, curative care and treatment procedures”.

Dr. Ajay Agrawal, Medical
Director-iKure

“Initially when I used to visit pregnant women, they were apprehensive and reserved. But repeated visits have given them confidence to open up. They ask many questions, show doctor’s report and ask for medicines. I have a joint family and few among them are pregnant, even they are educated, but they would consult me and ask for my opinion. I feel valued and found a voice through iKure”.

Gayathri Acharya
iKure CHW, Hubli, Karnataka

(Author: Dr. Tirumala Santra Mandal is a research and communication analyst at iKure. With a doctorate degree in corporate communication from IIT Kharagpur, she has worked in diverse fields of communications such as lie detection, multimedia communication, communicative English. Prior to working with iKure, she has worked as an editor and authored several publications in referred and business journals both at national and international levels.)