How We Made a Health App That Works in Remote Rural Areas without Internet

Over half a century ago, communications guru and public intellectual Marshall McLuhan predicted that electronic interdependence will make the world a global village. But last month, Simon Tisdall of The Guardian called out the international media for creating a hierarchy of suffering by focusing on Hurricane Harvey more than on the devastating floods in South Asia and South East Asia. The reason: distance! The distances that marginalize are not just physical. They manifest in governance gaps in justice, cultural atrophy and social dystopia. Nowhere is the tyranny of distance more manifest than in health care delivery. And the Himalayan state of Uttarakhand has the double burden of a hilly terrain along with metaphorical distances to bridge.

This is exactly what mSakhi works to achieve: bridging the tyranny of distance with a digital innovation in the form of an app that empowers the frontline health and nutrition workers. mSakhi is an Android-based app, freely downloadable, and designed for frontline health workers such as accredited social health activists (ASHAs, which also stands for hope) and auxiliary nurse midwives (ANMs). This app doubles as a register that combines the multiple registers these workers have to fill and maintain, and as a job aid cum trainer. It is a registration tool for pregnant and lactating mothers and their children, helps schedule home visits with each pregnant woman and hand-holds health workers through care and counselling sessions with expectant mothers and their family members.

mSakhi is open-source and uses Java and PHP language and MySQL database management system. A detailed story on the rationale for conceptualising and implementing the app in Uttarakhand has been carried by Youth Ki Awaaz here. “Last-mile delivery is the biggest challenge in governance in a hilly state, or for that matter, any state,” says Mr Chandresh Kumar, the current Mission Director Uttarakhand Health Mission. “Frontline workers are the face of any system. Empowering them and monitoring them is important to ensure last-mile delivery. Digital interventions should address precisely that, and mSakhi attempts to achieve exactly that”...