When alphabet fails, technology succeeds

“We had a tough time telling the family of a high risk pregnant woman to take special care of her and register for delivery at the district hospital. Despite repeated caution and reminders, the conservative family continued to ignore the well meaning advice.”

This was an observation shared by Rohit Gupta, former district collector of Churu district in Rajasthan, while recalling his experience of the launch of ‘Goad Bharai’ scheme that he had launched to create awareness on the care of high-risk pregnant women.

The ANMs (Auxiliary Nurse Midwifes) and ASHAs (Accredited Social Health Activists) working in the field in rural Rajasthan have to deal with such issues on a regular basis. The deep rooted prejudices are obvious hindrances in adoption of best health practices. Illiteracy, especially among women, makes things worse.

So where alphabets don’t work, can technology pitch in? Certainly, if one looks at the tech-savvy measures being employed by the Rajasthan government for effective communication and better monitoring of maternal and child health care.

Chief Minister Vasundhara Raje in the State budget this year announced training for all ASHAs in at least one district of each division for data entry on Tablet PCs. Once successful, the initiative will be replicated in all 33 districts. Similarly, ANMs in one district at each division will be given Tablet PCs to ensure effective monitoring of health and family welfare measures.

Some districts have already made a beginning in this direction. It started two years ago with a pilot project ‘e-Asha’ in the border district of Barmer. At least 25 health workers in Balotara block were trained under a joint project of UNICEF and the State health department.

The happy contagion is gradually touching other parts of Rajasthan as well. Almost all ANMs in Pali district are now tech-savvy, thanks to the initiative of the district administration and a philanthropic trust. Save the Children, a child rights organisation, has also provided Tablet PCs to their health workers in the tribal district of Dungarpur and Muslim dominated Tonk district.

The benefits of technology are immense, particularly when we have to communicate with mostly uneducated women, says Shahjahan, a health worker associated with Save the Children in Tonk.

“We have short films, actually interactive games on different subjects. We encourage women, and adolescent girls to play these games which have questions and answers on nutrition, vaccination, family planning, maternal and child care. They get numbers for the right answers and they understand things in a better way,” she adds.

The literacy rate has seen an upward trend in Rajasthan in the 2011 population census. But female literacy is still at a miserable 47.76 per cent in comparison to male literacy of 79.19 per cent. The sex ratio also leaves a lot to be desired as it lags behind the national average by 10 points. The 928 female for every 1000 male is below the national average of 940.

Diyali Patel, Sarpanch of Dayalupura, says while most of the women in the village are illiterate once the ANMs show them images on the Tablet PC, they quickly understand ( “jab chitra saamne aa jaataa hai to jaldi samajh me aa jaata hai” ). The pictorial messages are something even the elderly mothers-in-law and younger generation grasp quickly.

Manju Bohra, an anganwadi worker in Jaipur district says, “The government has made several provisions for malnourished children. Free medicines, food and also a daily allowance is available. Despite this, most of the mothers are not keen on getting admitted with the child at the malnutrition centre. The common refrain is, “ghar par bahut kaam hai” (there is too much work at home).

"They are not educated enough to understand the severity of their child’s malnourished status. In such a situation short films on health issues have a better impact.”

Another health worker feels that technology has made even the most reluctant of women interested in knowing more. Besides, her family members begin to understand that a pregnant woman needs better care.

The government aims to carry the tech-savvy measures further. Soon, all the health workers at 61,000 anganwadi centres across Rajasthan will be given android based mobile phones. It will help better monitoring of web based nutrition application ‘Raj Poshan’.

In a State where both the literacy level and sex ratio are a cause of concern, technology seems to be the new saviour.

(The writer is a Rajasthan-based freelance journalist. The article is done under the National Foundation for India's Child Survival Media Award 2014-15)

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