Khushi Baby, a 4-year-old global health technology NGO based out of Udaipur, Rajasthan, has been playing an unexpected, lead supporting role in the COVID-19 response for the Department of Health and Family Welfare and Government of Rajasthan (DMHFW).
Having developed, implemented, and rigorously evaluated a novel mobile health platform to track the health of over 30,000 mothers and infants over the last 3 years, Khushi Baby was invited to play a lead role in development and implementation of two major projects for the DMHFW this past year: 1) Establishment of IT-enabled Janta Clinics for provision of primary healthcare services to residents of urban slums of Jaipur and 2) the Nirogi Rajasthan Platform: a comprehensive digital health platform which will enable over 50,000 health workers across the state to conduct India’s first digital health survey of over 5 Cr residents and ensure community-based, longitudinal follow-up of reproductive and child health, NCDs, and other national health verticals.
In the midst of the COVID-19 pandemic, however, the launch of Nirogi Rajasthan’s digital health survey was delayed. In its place, health worker teams have been mobilized for COVID -19 related state-wide active surveillance efforts. Meanwhile, the Khushi Baby team has switched gears, adapting its tools for digital data collection, automated community outreach, localized content development, public health data analysis, and field operations to assist with the COVID-19 response at scale.
Khushi Baby has taken a lead role in assisting crisis communication at scale. The team launched Rajasthan’s WhatsApp COVID19 Chatbot on April 15 with over 20,000 unique active users to date. Beyond providing awareness on state-specific policies, this chatbot is the first to introduce features for symptom reporting, safe delivery for pregnant women, guidelines for health workers, and an option to sign up for a telemedicine consultation.
Furthermore, Khushi Baby’s automated, dialect-specific, voice call system is being scaled to reach nearly 6 lakh pregnant women and lactating mothers on a monthly basis to provide key IEC to increase awareness around maternal and child health care best practices. This voice call campaign also includes two-way calls to collect details on delivery and postnatal care outcomes directly from beneficiaries when frontline health workers may be occupied in other COVID-19 activities. This scale-up of the voice call system is grounded in prior evidence. In a two-year randomized controlled trial, Khushi Baby’s call system was found to decrease infant acute malnutrition by 26% and increase the odds of full infant immunization by 66%. But more importantly, with maternal child health nutrition camps suspended for two months due to COVID-19, over 12 lakh infants run the risk of missing key immunizations if their parents are not adequately informed and motivated.
Beyond enhancing communication efforts, Khushi Baby is also directly involved in supporting digital public health surveillance efforts. By liaising with the Department of IT&C, the Infectious Disease Surveillance Program, and WHO teams, Khushi Baby has helped to streamline data collection processes. This has allowed the DMHFW to take a data-driven approach to the deployment of frontline health workers to better target communities with a high prevalence of cases, medically, and socially vulnerable communities, under the program banner ‘Mission Lisa’ (for Life-Saving). These frontline health workers are also using a mobile application to collect data from the field, also developed by the Khushi Baby team in an offline manner. The Mission Lisa application, a subset of the Nirogi Rajasthan Platform, assists with the preparation of beneficiary due-lists, point-of-care decision making, and risk assessment of vulnerable groups in the community.
To implement these projects, the Khushi Baby team has worked closely with the DMHFW and has even had a chance to play an advisory role to the Additional Chief Secretary Health among a broader panel of experts and administrators. The team played a key role in drafting policy related to testing, quarantine, active and passive surveillance, and lockdown modification for large urban outbreaks, such as the one which took place in Ramganj, Jaipur.
Moving ahead, Khushi Baby’s role as a field operator will be key to the success of the deployment of the Nirogi Rajasthan Platform. This strength in implementation has already been demonstrated during the COVID-19 outbreak through the support of over 20,000 OPD visits across 4 Janta Clinics in the Ramganj outbreak area and through the delivery of 115000 triple layer masks and 7500 N95 respirators to the Rajasthan State Medical Services Corporation. Now with the launch of Mission Lisa this week, Khushi Baby’s efforts for screening the most vulnerable will be felt across the state.
During this time, NGOs have had to make tough decisions to restructure their programs, organizational structures, and funding sources after seeing donor and government focus shifts towards the COVID-19 pandemic. Khushi Baby’s ability to contribute effectively is a testament to its multidisciplinary public health toolbox, grassroots and policy experience, organizational agility, and earned trust with the Department of Health through its sincere approach to problem-solving.
The DMHFW has also taken bold steps under the leadership of Additional Chief Secretary Health, Rohit K Singh, to create an ecosystem to foster social impact and innovation. Last month, this partnership was formalized between the DMHFW and Khushi Baby in a three-year contract, in which Khushi Baby pledges to provide services free of cost. This week, the Central Ministry of Health and Family Welfare approved a 17.5 Cr resource envelope to support the program related costs related to the technology, to scale Khushi Baby’s maternal and child health tracking platform to 13,000 health workers serving 6 lakh mothers and infants in five of Rajasthan’s largest districts.
Moving forward, local ingenuity will need to be further nurtured in order for Rajasthan and other states to address the unfinished public health agenda. Taking Khushi Baby as an example, governments should continue to lean into mission-oriented organizations with youthful innovation.
