How Swasth Nari campaign signals a shift in India’s approach to women’s health 

Second, the campaign’s massive community mobilisation that involved more than 5 lakh Panchayat representatives, 1.14 crore students, 94 lakh Self-Help Group members, and 5 lakh other community members represents a fundamental shift towards decentralised and distributed healthcare. Unlike top-down delivery models that position women as passive beneficiaries, this “whole-of-society” framework creates multiple nodes of engagement and accountability. 

The participation of SHGs members is particularly significant, given that these collectives have historically functioned as spaces where women develop organisational capacity, financial literacy, and collective voice – assets that can translate into health advocacy and rights-claiming.

But perhaps what makes the notable difference is the campaign’s utilisation of digital platforms in democratisation of information and access to healthcare. The fact that nearly 10 lakh women registered for breast cancer screening online within a single week suggests that when designed properly, digital tools can overcome traditional barriers of distance, mobility constraints, and institutional hurdles that have limited women’s healthcare access, especially in rural areas.

Digital turn in women’s healthcare

India’s journey towards digitising women’s healthcare began in earnest in the mid-2000s, marking a shift from manual, paper-based record system to data-driven health governance utilising digital tracking systems. Over the years, India has deployed diverse technologies, including Interactive Voice Response Systems (IVRS), SMS, telemedicine, and mobile health applications, to strengthen maternal healthcare. Notably, these choices have been shaped by the targeted population’s socioeconomic status and literacy levels. 

The Mother and Child Tracking System (MCTS), launched in 2009, represented the first systematic attempt to create digital registries for pregnant women and children, aiming to track immunisation schedules and antenatal care visits. This evolved into the Reproductive and Child Health (RCH) portal, which consolidated multiple vertical programmes into an integrated digital platform. 

The Kilkari mobile health programme, rolled out in 2016 as a part of the Digital India Initiative, delivers 72 weekly automated voice messages in Hindi – from 18 weeks of pregnancy through the child’s first birthday – covering nutrition, supplementation, pregnancy care, and family planning to those women registered in the RCH portal. The programme now reaches over 29 million women across 18 states and union territories.

Meanwhile, the eSanjeevani telemedicine platform, integrated into the public system, has delivered over 100 million consultations since 2020. Government data suggests that women constitute the majority of beneficiaries, with more than half of consultations pertaining to female patients. 

The rollout of the National Digital Health Mission in 2020 – later rebranded as the Ayushman Bharat Digital Mission (ABDM) – marked an acceleration toward a comprehensive health data infrastructure. The COVID-19 pandemic functioned as a catalyst, normalising telemedicine, digital health records, and mobile health applications, while the Co-WIN platform demonstrated the state’s capacity for mass digital health coordination. These infrastructures have since been efficiently utilised for women’s health initiatives, as evidenced by the recent SNSPA campaign.

But what does the impact assessment reveal?  

Digitisation has yielded measurable improvements in certain dimensions of healthcare delivery. Studies on the mMitra voice message service for maternal health indicate that digital tracking systems have improved immunisation coverage by enabling automated reminders and reducing dropout rates between vaccine doses, apart from aiding doctor consultations for bleeding and promoting institutional child delivery. 

Research proves that mobile health applications used by frontline health workers have increased antenatal home visits by 15.7 per cent and postnatal visits by 12 per cent, while facilitating health education and systematic screening. The ability to generate real-time data on service delivery gaps has enhanced administrative visibility, potentially enabling more responsive resource allocation. 

However, the impact assessment reveals significant complexities. For instance, Aadhaar-based authentication systems have generated substantial exclusion with authentication failure rates depending on context and demography. The significant gender divide in technological access and digital literacy further creates new forms of gatekeeping, where women’s access to maternity benefits becomes contingent not just on eligibility but on successful navigation of complex digital verification processes. 

For pregnant women specifically, biometric authentication methods like fingerprint recognition face challenges due to swelling, manual labor-induced wear, or poor connectivity in rural health centers. Digitisation also risks overburdening ASHAs and ANMs, who must simultaneously perform care work and extensive data entry into multiple, often poorly integrated platforms.

Women at the intersection of data, algorithms, and access

The Health Data Management Policy for ABDM emphasises “security and privacy by design” and sets minimum standards for consent, data minimisation, and purpose limitation. But the lack of operational data-protection standards  would precipitate the risk of function creep, once reproductive and health data are linked to unique identifiers.

State-level initiatives like Haryana’s proposal to assign unique “pregnancy IDs” linked to the RCH portal may help illustrate this. Although the initiative aims at improving monitoring of sex-selective abortion and ensuring maternal healthcare benefits, it also illustrates how digital infrastructures can be deployed both to protect and to discipline women’s reproductive lives.

The transition from fragmented pilot projects to national-scale data infrastructures has expanded information flows, improved continuity of care, and enabled new modalities of engagement. This is done particularly through the national digital health ecosystem with unique health IDs, health-facility and interoperable electronic records.  

But gendered disparities in device ownership and digital literacy, opaque algorithmic classifications, interoperability glitches amongst platforms, and last-mile infrastructural breakdowns continue to undermine equitable access for women. Digitisation’s significance for women’s healthcare in India hence rests in its dual capacity to transform access while simultaneously reproducing structural inequities.

Future of digital health lies in inclusion, not just sophistication

Nonetheless, a more progressive trajectory could be possible if digitisation is reframed through an inclusive approach that takes into account the intersectional vulnerabilities of women in India.

This requires prioritising low-tech, multilingual channels (SMS, WhatsApp Chatbots & IVR) co-designed with women users; strengthening enforceable consent, grievance and redress mechanisms. The digital tools need to be used to support rather than replace community health workers, enabling ASHAs to leverage data for advocacy and claim-making, not just reporting. 

Ultimately, the future of digital health will be determined not by technological sophistication but by how questions of gender, justice, and accountability are embedded into system design.

Digitisation can advance women’s health only when it redistributes power, protects autonomy, and actively mitigates the inequalities it risks entrenching – an imperative now made tangible by initiatives like the Swasth Nari, Sashakt Parivar Abhiyaan, signalling India’s readiness to translate scale into sustained structural transformation.

Post read questions

How does the Swasth Nari, Sashakt Parivar Abhiyaan signal a paradigm shift in India’s digitisation of women’s healthcare compared to earlier fragmented initiatives?

How have digital innovations such as the Mother and Child Tracking System (MCTS), the Reproductive and Child Health (RCH) portal, Kilkari, and eSanjeevani shaped maternal and reproductive healthcare outcomes in India?

Do you think gendered disparities in device ownership and digital literacy limit the transformative potential of digital health platforms? Illustrate. 

Why is community mobilisation—through Panchayats, SHGs, students, and local stakeholders—critical to the success of digital health interventions like SNSPA?

What would a gender-just digital health ecosystem look like in practice, especially for low-literacy and low-connectivity populations?

(Shamna Thacham Poyil is a Doctoral Research Scholar in the Department of Political Science, University of Delhi.) 

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