Catholic Relief Services partners with technology innovator Dimagi, Inc. and Vatsalya to implement the Reducing Maternal and Newborn Deaths (ReMiND) Pilot Project in 2 blocks of Kaushambi district in Uttar Pradesh (India). ReMiND works with government community health workers (called ASHAs) to improve the frequency and quality of pregnancy, postpartum and infant home visits. ASHAs use basic mobile phones operating Dimagi's open-source CommCare software, which equips them with multi-media job aids to support client assessment, counseling, and early identification, treatment and/or rapid referral of pregnancy, postpartum and newborn complications. This presentation details the content and workflow of the CommCare-based mobile application developed for and used by ASHAs through the ReMiND Pilot Project.

1. OVERVIEW OF REMIND
CONTENT & APPLICATION
STRENGTHENING ASHA HOME VISITS FOR
MATERNAL, NEWBORN AND CHILD SURVIVAL
UP-NRHM SITE VISIT TO REMIND
JULY 2013 – KAUSHAMBI DISTRICT

2. PROJECT OVERVIEW
Reducing Maternal and Newborn Deaths
(ReMiND) Pilot Project
• Partners: CRS, Dimagi, Vatsalya
• Area of Intervention:
2 blocks of district Kaushambi District (Manjhanpur &
Mooratganj)
• ASHAs covered: working with 255 by end May 2013
• Project Duration: 3 Years (Oct 2011 – Sept 2014)
• Donors: CRS’ Private Fund and USAID DIV 2.0 Fund
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3. COMMCARE –
REMIND’S TECHNOLOGY PLATFORM
CommCare as a Job Aid for ASHA:
- Track and support woman through
Pregnancy and Postpartum periods
- Track and support baby from birth through
first 2 years of life
- Localized and designed for ASHA use
 Combines audio and still images for
counseling and assessment content
based on ASHA Modules 2, 6 and 7
CommCare as a Reminder tool:
- SMS reminders sent to ASHAs to remind of
upcoming visits and alert supervisor of
missed visits
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CommCare as a Decision Support tool:
- Helps the ASHA identify Danger Signs and make the appropriate referral

4. SMS reminder
to ASHA
ASHA Registers
Pregnant
Woman
ASHA Conducts
Pregnancy
Home Visits
Delivery
DANGER
SIGN
DETECTED
Job Aid: assessment,
counseling & data collection
Referral &
Treatment in
Health Facility
PREGNANCY WORKFLOW
4

5. SMS reminder to ASHA and
missed visit alerts to supervisor
Postpartum Home
Visits for Mother –
Days
(0),3,7,14,21,28,42
End of
Post-
Partum
Period
DANGER
SIGN
DETECTED
Job Aid: assessment,
counseling & data collection
Home Treatment
or Referral to
Facility
POSTPARTUM & NEWBORN WORKFLOW
5
Newborn Home
Visits for Baby –
Days
(0),3,7,14,21,28,42
Mother’s Case
Closed
Delivery

6. SMS reminder
to ASHA
Infant tracked
through Year 2
for Routine
Immunizations
Infant Case
Closed
Job Aid: assessment,
counseling & data collection
YOUNG CHILD WORKFLOW
(UP TO 2 YEARS OF AGE)
6
End of
Post-
Partum
Period

7. 7

8. REMIND APPLICATION SUMMARY:
Five Modules to Guide the ASHA Workflow:
1. Registration of Pregnant Mothers
2. Management of Pregnant Mothers
3. Management of Postpartum Mothers
4. Management of Newborns & Young Children
5. Referral Follow-Up
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9. - Pregnancy Checklist
- Completion of ANC check-ups and Tetanus
Immunizations, Assess Use of Health Services,
Assess High Risks Signs in Pregnancy
- Pregnancy Counseling
- Information about High Risks and Pregnancy
Danger Signs, Antenatal Care, Nutrition, Rest
and IFA, Pregnancy Danger Signs, Birth
Planning and Preparedness, Essential Newborn
Care
- Pregnancy Outcome
- Delivery information, Pregnancy outcome,
Newborn and mother’s health after delivery
- Modify Pregnant Woman Info
- Modify identification info for woman, and update
EDD/LMP information
PREGNANT MOTHERS:
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10. - Mother Postpartum Visit
- HBNBC Mother Form
- Postpartum Counseling
- Information about High Risks and Postpartum
Danger Signs
- High Risk Follow up*
- Follow-up on high risks identified, Decision
support for assessing high risks
- Postpartum Review
- Provides summary of information about status
and health of postpartum mother, high risks
identified, and next scheduled home visit
- Close Postpartum
- To be filled 42 days post delivery once
postpartum phase is complete
POSTPARTUM MOTHERS:
10*Note – currently undergoing field testing

11. - Home-based Newborn Care Visit
- HBNBC Baby and CCSP forms
- Breastfeeding Assessment
- Additional follow-up for any mother/newborn with
a suspected feeding problem.
- Routine Immunization Tracking through 2 years
- BCG, OPV, DPT, Boosters, Polio, Measles, VitA
- Routine Immunization Counsel
- Information about vaccines, benefits of
immunization, side effects, how/where to go
- Update Baby Info
- Update any details about the newborn case
- Close Baby
- To be filled to close the baby case after 2 years of
care and full immunization
YOUNG CHILD:
11*Note – currently under design

12. SUMMARY
The ReMiND Pilot Project uses
CommCare to:
- Provide a Job Tool for the ASHA to
improve many aspects of her
work, including:
- counseling
- timeliness of visits
- tracking of mothers and children
- identification of danger signs
- following up with referrals
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- Use the power of mobile phones to collect data on service
utilization and key MNCH practices
- Collect data in Real Time that can be used by supervisors and
project managers immediately

13. SUMMARY OF BENEFITS
Improved Work Quality:
- Checklists improve
performance
- Decision support
increase adherence to
protocols
- Validation and skip
logic to improve
quality of data
- Reminders to ASHAs
of upcoming visits &
referral follow-up
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14. 14
THANKS

15. Assess Use of Health Services:
Early registration with ANM, TT
Vaccination, ANC 1/2/3/4
DANGER
SIGN
DETECTED
FORM EXAMPLES: Pregnancy Checklist Form
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Immediate Referral
Assess Pregnancy Danger
Signs
Assess Behaviors:
IFA Consumption, increased nutrition,
proper rest, birth preparedness
Referral Follow-Up Form:
ASHA provides update on client’s condition &
referral status (complete/incomplete) 24 hours
after danger sign identified
SMS
Reminder to
ASHA to
Follow Up

16. Visit Status Labels:
No. of days since delivery, no. of HBNBC
home visits conducted to date, whether
current visit on time as per HBNBC
schedule
FORM EXAMPLES: Postpartum Home Visit Form
(HBNBC Mother Form)
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HBNBC Mother Assessment as
per NRHM form
Home Management
as per protocol
Referral Follow-Up Form:
ASHA provides update on client’s condition &
referral status (complete/incomplete) 24 hours
after danger sign identified
SMS
Reminder to
ASHA to
Follow Up
Immediate Referral
as per Protocol
NEWBORN
COMPLICATION
IDENTIFIED
SMS
Reminder to
ASHA to
Conduct Visit
SMS missed visit alert sent to ASHA
supervisor if visit not completed on time

17. Visit Status Labels:
No. of days since delivery, no. of HBNBC
home visits conducted to date, whether
current visit on time as per HBNBC
schedule
FORM EXAMPLES: Postpartum Home Visit Form
(HBNBC Baby Form & CCSP Form)
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HBNBC form for baby
Home Management
as per protocol
Referral Follow-Up Form:
ASHA provides update on client’s condition &
referral status (complete/incomplete) 24 hours
after danger sign identified
SMS
Reminder to
ASHA to
Follow Up
Immediate Referral
as per Protocol
MATERNAL
COMPLICATION
IDENTIFIED
SMS
Reminder to
ASHA to
Conduct Visit
SMS missed visit alert sent to ASHA
supervisor if visit not completed on time
CCSP Form:
If signs of infection or feeding problems
identified with HBNBC form