Welcome to 104https://indianexpress.com/article/news-archive/web/welcome-to-104/

Welcome to 104

A toll-free number offers round-the-clock support to around 2 lakh health workers across Maharashtra

A month ago,in Osmanabad district,one of the auxiliary nurse midwives (ANMs) helping a woman in labour found herself in a tricky situation. Even 10 minutes after the delivery,the baby had not started crying. She fumbled for her phone and dialled 104 immediately. The call was answered by a paediatrician who advised the ANM to first wrap up the baby,rub her feet to keep her warm,check her heart rate and give oxygen,and to carry out suction to make the baby cry. A little later,when the paediatrician followed up with her to check up on the baby,she had broken into cries and was stable.

As many as two lakh health workers,deployed in various parts of Maharashtra,reach out to 104 every time they face a health-related problem. The number,104,is a toll-free number of the 24×7 Health Advice Call Centre (HACC) in Pune,which was started by the National Rural Health Mission and is run by the Health Management and Research Institute,a non-profit organisation based in Hyderabad. The project,launched in January 2012 and operating from Aundh Chest Hospital in Pune,was started with an objective to support the health workers of the state. “These health workers don’t work in hospitals but they visit villages and attend to patients. ANMs,anganwadi sevikas,health assistants,lab technicians and even pharmacists call in for advice,” says Niraja Banker,operations manager at HACC.

“Namaskar,104 madhe swagat aahe (Namaskar,you are welcome to 104),” says a Health Advisory Officer,referred to as an “agent”. The caller’s number and other details are registered with the helpline. “And then we give the health advice required by the caller. The agents use a software called Algorithms,where advice is provided based on symptoms. However,if special advice is needed,specialists like gynaecologists,paediatricians and physicians attend to the calls,” says Banker.

For instance,in March,an ANM from Khandala had called about a woman undergoing a complicated labour. The gynaecologist at the centre quickly took over and guided her to a step-by-step delivery. The ANM was also asked to call her Medical Officer as the child would need resuscitation when delivered. A follow-up call revealed that the child and mother were safe and it was a normal delivery.


A 10-seater call centre,HACC has 35 to 40 agents and doctors on call round-the-clock,working in three shifts—7 am to 2 pm,2 pm to 9 pm and 9 pm to 7 am. Agents are required to be at least pharmacists or BMS doctors,and knowledge of Marathi is a must. Before the agents start taking calls,they are given thorough training for 15-20 days. “It’s a developing field and so to keep the agents updated,we conduct training at regular intervals,” says Banker.

“We attend around 1000 calls in a day. We even call back people whose calls we miss. There are follow-up calls made by doctors too,” explains Banker. Most of the calls they receive are from districts such as Bhandara,Nanded,Ahmednagar,Amravati and Yevatmal.

Since 2012,the centre has received 392,381 calls. Interestingly,the centre also receives calls from the general public. “We don’t deny them any health-related advice,” says Banker.