Post on 16-Jul-2015
Improving the Quality of Engagement Between Pregnant Women and ASHAs in Kaushambi District of Utter Pradesh, India elin.murless@crs.org / farhad.ali@crs.org
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UttAr PrADESHUttar Pradesh (in red) showing Kaushambi district (in black).
One in every 35 people in the •world lives in Uttar Pradesh Uttar Pradesh has some of India’s •worst statistics for mother and child survivalthe reMiND program is in •Kaushambi district which is one of 25 high-focus districts for health in Uttar Pradesh. the district has neonatal, maternal and child mortality rates far greater than national averages (respectively, 84%, 92 % and 103 % higher)
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Methodthe usefulness of the supervisory application of SFs on improving the quality of engagement between ASHAs and pregnant women was assessed through a comparison of September 2012, 2013 and 2014 checklists on quality parameters of home-based observations. Data was downloaded and percent responses on quality parameters were calculated.
resultsAll 16 quality parameters have shown an overall increase over the two-year period. It was found that 17.6 % more pregnant women were greeted by ASHAs, and that 59.3 % more ASHAs expanded on any of the audio messages. A 59.3 % increase in ASHAs who waited for the woman to respond before moving to the next audio message, and a 65.5 % increase in ASHAs who encouraged women to ask questions was observed. Pregnant women who asked any questions rose by 220.8 %, and family members who asked questions increased by 218.1 %, a marked improvement in engagement of ASHAs with family members. ASHAs who encouraged women to use the next recommended health service increased by 100 % and ASHAs who talked about their next home visit increased by 92.7 %.
ConclusionreMiND has responded to a challenge where the health system has lacked the capacity to systematically collect and analyze performance data of ASHAs. technology and real-time data has focused the supportive supervision that SFs give, and improved ASHA performance.
Introductionthe reducing Maternal and Newborn Death (reMiND) project works with accredited social health activists (ASHAs) in Kaushambi District using basic mobile-phones operating multimedia job aids to support client assessment, counseling, and early identification, treatment and rapid referral of pregnancy, postpartum and newborn complications. Catholic relief Services, partnering with global innovator Dimagi and local implementing partner Vatsalya, has strengthened the supportive
supervision structures for ASHAs through project-supported sector facilitators (SFs) that act as ASHA supervisors. SFs use mobile-phone-based monitoring tools to guide supportive supervision, conduct routine observations of the quality of ASHA counselling during home visits, and follow up on poorly performing ASHAs. All real-time data is transmitted from the applications to a cloud-based server where project supervisors can monitor and support ASHA activities.
ASHA greeted woman
ASHA expanded on CommCare audio messages/questions
ASHA waited for client to respond before moving to next question
ASHA encouraged client to speak or ask questions
Clients who asked any questions
Families who asked any questions
ASHA encouraged woman to use next recommended health service
ASHA talked about her next home visit
Improvements in ASHA counseling tracked through facilitator observations
Elin Murless | Program Quality, Health | elin.murless@crs.orgFarhad Ali | technical Expert, Health | farhad.ali@crs.org
Poster ReMiND 2.indd 1 1/29/15 10:40:49 AM