The
following section provides an overview of the few mHealth initiatives carried
out in India to provide information, create awareness and bring out behavioral
changes in women. According to the latest government data, India’s infant
mortality rate (IMR) declined from 37 per 1000 live births in 2015 to 34 per
1000 live births in 2016.  Mobile
technology can be attributed to the decline in this number which contributed to
the reduction in delay in accessing maternal health. mHealth helps in improving
access, coverage and addressing gaps in delivery. However, it has been observed
that using mobile camera photos for diagnosis led to a reduction in the
accuracy of diagnosis. Several studies have shown the effectiveness of mHealth
technologies in advancing maternal and child health care in low and middle
income countries (Tamrat et al., 2012; Noordam et al., 2011 ; Sondaal et al.,
2016). Yet, there is still a long way to go to meet the 2019 target of IMR 28
per 1000 live births (Kaul, 2017).

In 2012, a
public health program to improve maternal and newborn health was initiated in
Bihar by Care India with the support of Bill and Melinda Gates Foundation with
the overall goal of achieving the Millennium Development Goals (MDG) 4 and 5.
As an innovation in this program, the Continuum of Care Services (CCS) –
(Maternal and Child) was introduced using an mHealth platform. Out of total
3000, 500frontime workers including Accredited Social Health Activists,
Anganwadi Workers, Auxilliary Nurse Midwives and Lady Health Supervisors were
trained to use the mHealth platform. The service delivery components namely
early registration of pregnant women, three antenatal visits, tetanus toxoid
immunization of the mother, iron and folic acid tablet supply, institutional
delivery, postnatal home visits and early initiation of breastfeeding were used
as indicators for good quality services. The resultant coverage of these
services in the implementation area was compared with rest of Bihar and
previous year statistics of the same area and it was observed that this
intervention helped in strengthening the coverage, quality, equity and
efficiency of services (Ramkrishnan et al., 2016). The Sisu Samrakshak (SSK)
program in Andhra Pradesh, India, which was funded by the UNICEF, has been running
since 2000. It demonstrates the incorporation of data management into primary
health care services using mobile technology. Handheld devices are used by the
“Anganwadi” workers to monitor the health development in the catchment area and
communicate the data to the nearest rural health centers. Subsequently, the
same mobile device disseminates necessary information related to topics such as
pregnancy, nutrition, and immunizations (Rao, 2009). Yet in another initiative
by UNICEF’s MAPEDIR (Maternal and Perinatal Death Inquiry and Response) aimed
to tackle the maternal mortality at the family, community, health service, and
policy-making levels. Emergency medical support in Madhya Pradesh was provided
with the help of 24 hour obstetric help line support to community members and
health workers which helped in reducing delays associated with when to seek
medical care, identifying healthcare facilities for appropriate service and
care delivery. mHealth initiatives have been used to collect data on
immunization and prenatal care visits in Haryana, with the help of handheld
computers (Mechael, 2009).In another initiative in Andhra Pradesh, a provision
of handheld computers aided to collect and monitor nutrition, maternal and
child health activities.

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