A renowned Urogynecologist and founder of India-based non-profit in India – ARMMAN – Dr. Aparna was recently selected as one of the winners of the prestigious 2021 Elevate Prize. This accomplishment also comes in line with being #15 on Fortune’s list of World’s 50 Greatest Leaders 2021 and the Skoll Award received for Social Entrepreneurship in 2020.
In conversation with Rusen Kumar, Editor, India CSR, Dr. Aparna gives a detailed overview of the different tech-based approaches that were recognised and the models undertaken to create cost-effective and highly scalable solutions in this space. Besides highlighting the recent collaboration with Google as part of their ‘AI for Good’ initiative, she discusses the scope and the challenges that she sees laying ahead. “COVID-19 highlighted the importance of digital solutions and demonstrated the potential of ARMMAN’s interventions”, she further laid out how she sees the organisation in the coming years.
What was the thought process around implementing technology-based solutions when you started ARMMAN 13 years ago?
The idea of ARMMAN germinated during medical residency, where everyday I would witness pervasive systemic gaps leading to preventable maternal/child deaths and morbidity. The scale of India’s problems made it evident that any solution I designed must be scalable and cost-effective. That was around the time that the mobile phone came to India, and the idea struck me – why not use a simple tool like a mobile phone which is available in almost every Indian household to bridge the yawning systemic gaps in health care? That is how ARMMAN was started in 2008.
Our “tech plus touch” approach leverages the existing frontline health worker network of the government and partner NGOs and combines it with the ubiquity of the mobile phone, to achieve scale cost-effectively without duplicating efforts. While our mature programs use technology for scale and quality, we pilot innovations using new technologies to keep pace with technological advancements for bettering health outcomes. Programs implemented by ARMMAN have now reached 26 million women and children and trained 212,000 frontline health workers in 19 states of India.
Tell us more about the “tech plus touch” approach and why that is essential to the success of your programs.
ARMMAN’s programs are designed for scale without dilution of impact by combining technology with ‘community needs assessment’ approach and evidence-based research. Our innovative ‘tech plus touch’ model combines our tech-enabled interface with the beneficiary/health worker with a human interface provided by the call center/field staff. This enables limited human resource requirement inspite of multiple touch points, leading to nonlinear growth at extremely low cost; for example, it costs USD 1 to send calls to a woman covering pregnancy and infancy through Kilkari and train an ASHA worker through Mobile Academy. We partner with the national and state governments, 97 hospitals and 41 on-ground NGOs. We leverage the existing frontline health worker network of the government and partner NGOs without creating parallel structures.
One of your collaborations is with Google as part of their ‘AI for Good’ initiative. How are you using AI in your programs?
ARMMAN has partnered with Google Research, India (AI for Social Good); CRCS, Harvard University; and IIT Chennai to use Artificial Intelligence to predict the risk of expectant mothers dropping out of our mMitra program along with creating targeted interventions to improve positive healthcare outcomes.
The pilot is already showing encouraging results – AI could enable ARMMAN to increase the number of women engaged through the program by 50%. I am confident that this partnership will bring immense benefits in the future as we scale the model to more women enrolled in the mMitra program.
Other technology innovations being piloted include two-way communication with the women using WhatsApp as a tool rendering multimedia content instead of a voice only approach.
You were recently selected as one of the winners of the Elevate Prize powered by the Massachusetts Institute of Technology? Tell me more about this prize and how it will help the organization.
We have been selected as winners of the prestigious 2021 Elevate Prize for our use of mobile technology to enable healthy pregnancies, safe deliveries, and healthy childhood. This prize is awarded by The Elevate Foundation in collaboration with MIT Solve, an initiative of the Massachusetts Institute of Technology. The 10 winners were selected out of 1273 applicants from 92 countries and ARMMAN was recognized as one of 2 winners from India. I feel honoured that our innovative approach of using the “tech plus touch” model that combines technology with strong on-ground linkages and partnerships has been recognised globally.
Winning the Elevate Prize will support our ambitious scale-up plans, COVID-19 interventions, and innovations in the use of AI and predictive analytics, multimedia and a two-way communication approach. It will catalyse collaborations with multilateral agencies, support organizational development and provide access to critical funds. It will also help us firm up a blueprint roadmap for ARMMAN, bringing us closer to our vision of a world where every mother is empowered and every child is healthy.
You have partnered with the central government for the implementation of Kilkari and Mobile Academy, the largest mHealth programs of their kind in the world. Tell us more about this partnership.
ARMMAN’s demonstrated success with mMitra led to the partnership with the Ministry of Health and Family Welfare in January 2019 for the implementation of their Kilkari and Mobile Academy programs. Kilkari is the largest mobile-based maternal messaging program in the world and has reached 23.6 million women in India to date. Similarly, Mobile Academy is the largest health-worker training program in the world; over 212,000 frontline health workers (ASHAs) have been trained so far. Both these programs are currently being implemented in 17 states with pan-India expansion planned by 2025.
When COVID-19 struck in early 2020, we set up a Rapid Response System to send critical information through calls/text messages to 800,000 health workers in partnership with the central government. We are also supporting the government in its month-long door-to-door COVID-19 vaccination campaign called ‘Har Ghar Dastak’ aimed towards full vaccination in poor-performing districts by sending calls and messages to frontline health workers.
Apart from the central government, we have also partnered with the state government of Telangana to implement an integrated approach to improve identification, tracking and end-to-end management of high-risk pregnancies in the state over 5 years. The Integrated High-Risk Pregnancy Management (IHRPM) project trains Auxiliary Nurse Midwives (ANMs), Medical Officers (MOs) and Specialists in High-Risk pregnancy management protocols, supported by the Learning and Tracking App.
How can a corporate support ARMMAN?
Corporates can offer their expertise and experience in AI, data, research, branding, marketing, talent management and more. They can also partner with us on specific projects and get a closer look at how ARMMAN operates on the ground, working closely with partners at the grassroots level to implement our programs.
With mobile health and digitisation taking more precedence during and post the pandemic, what are the scope in this space and the challenges you see?
COVID-19 highlighted the importance of digital solutions and demonstrated the potential of ARMMAN’s interventions. We adapted our extensive technology platform and expertise and within a week, launched 4 COVID-19 interventions to support pregnant women, children and health workers with access to critical information and services in rural and urban areas. These tech-enabled initiatives will continue to be extremely relevant in the physical and social distancing norms mandated by COVID-19 and in the post-COVID world, and we will look at scaling these programs pan-India with the help of the Health Ministry in the future.
While technology is a great enabler it can also potentially reinforce the same inequities that it tries to address. We are looking more closely at integrating empowerment and equity into our programs in a tangible manner while designing and testing tools that can be used to measure the progress. The innovations we are testing are in alignment with ARMMAN’s pyramidal “fit for purpose” approach where low-risk women at the base of the pyramid get broad-based content while those with high-risk conditions or the most disadvantaged with the least equity get more targeted content with greater handholding support through 2-way communication. Thus, a needs and access-based blended “tech plus touch” model will be deployed depending on risk categorisation and access to smartphones/feature phones.
Apart from tracking programmatic indicators, we will also take deeper cognisance of ecosystem indicators while strategizing in order to design and implement more equitable solutions.
Where do you see ARMMAN in the next 5 years?
Over the next five years, we will strengthen and scale our existing interventions and launch new interventions. We have plans to scale across the country to reach 45 million women via Kilkari and train over 1 million health workers through Mobile Academy by 2025. The next versions of both these programs will focus on two-way communication, multimedia content and a pyramidal structure to address high-risk pregnancies and infancies. Successful pilots (AI/ WhatsApp) currently being tested in the mMitra sandbox will be scaled via Kilkari to reach a larger number of women and children. We will also focus on the creation of a technology platform with backend data integration with AI across programs for monitoring and tracking high-risk beneficiaries with planned targeted interventions.
(CopyRight@IndiaCSR)
