From guidance on tobacco cessation to counselling on tuberculosis management, from audio messages on pregnancy and child care to mobile-based trainings to frontline health workers, new m-health services have recently been launched by the Ministry of Health & Family Welfare, Government of India. While moving to mobile platforms is a commendable step, one is compelled to analyse whom these services really help and how.
Although India has seen a significant reduction in its Maternal Mortality Ratio and Infant Mortality Rate in the recent years, a further reduction in maternal and infant deaths is by no means an easy task. This is particularly true for states such as Jharkhand where around 40 per cent women still receive less than three Ante Natal Care checkups during their pregnancy (Annual Health Survey 2012-13) and 43 per cent children still do not receive breastfeeding within one hour of birth (Annual Health Survey 2012-13). Given this scenario, it appears that the launch of ‘Kilkari’ literally meaning ‘the gurgle of a baby’, a mechanism for delivery of free, weekly, time appropriate audio messages about pregnancy and child care directly to the mobile phones of the mothers/ family members would go a long way in improving knowledge about care during pregnancy and child birth.
ASHAs (Accredited Social Health Activists), the frontline workers of NHM, are the face of the mission and are actively involved in counselling and mobilising women on the healthcare front. The 8th Common Review Mission of the National Health Mission, while highlighting the achievements of the ASHA programme, clearly indicates that there are gaps in knowledge and skills of ASHAs and also points to the need for increasing the pace of training across states.
In view of this, the mobile academy designed to provide free audio training courses to ASHAs to increase their capacity to appropriately counsel pregnant women and children can definitely be a quick and effective way to bridge the knowledge gap. Now there would be no need for an ASHA to travel for hours to reach the district headquarters to learn about care during pregnancy. There is no chance of her missing out on the training, due to social and geographical conditions, as she can take the training as and when she is ready for it and can receive a certificate once she completes her course.
Given that India has the largest number of TB cases in the world, almost 23 per cent of the global total, there can never a case of too many interventions for combatting the disease. It is in fact critical and compulsory that every effort be made to screen all suspected cases, track each and every TB patient in India and ensure that he or she completes his/ her treatment. It is thus not surprising that the Ministry has launched a Citizen Centric Missed Call Centre for reaching the unreached TB patients. As part of this, a dedicated toll free number with a Call Centre is being started to provide patient counselling and treatment support services. Any person with symptoms and signs suggestive of TB including cough >2 weeks, fever >2 weeks, and significant weight loss can give a missed call to 1800-11-6666 to get complete support for diagnosis, treatment and completion of treatment for tuberculosis.
Even the rarest of the rare visitor of the movie theatres must have witnessed the screenings on the horrifying effects of tobacco consumption before the start of a movie. Tobacco kills almost one million persons in India every year. Addiction to tobacco is a risk factor for many chronic/ life threatening diseases. Most tobacco users are aware of this, but for those who really want to let go of this habit, the challenge is mammoth. If one recognises this, I think he/ she can appreciate the need for the m-cessation initiative of the Ministry. Any tobacco user willing to quit tobacco can give a missed call to 011-22901709 for registration. Alternatively he/she can also e-register through the national health portal whereby QUIT NOW SMS’s would be sent to the user. More than 150 SMS’s have been designed to help support the user quit tobacco.
The schemes are being rolled out in a phased manner and this would give the Ministry ample opportunity to evaluate the feasibility and effectiveness of these initiatives in difficult areas. Lastly it may be said that while the above four ideas, using the hassle free and cost effective m-platform, are well designed and address problems that are very tangible and visible, the real challenge lies in popularizing them among the end users and ensuring effective implementation. Whether the chronic killers bow down to these fantastic four crusaders is something that only time can tell, but one must appreciate and applaud the government for a well-armed march into the right direction.