1. Designing an M&E System
For Maternal Health in
Jasola
GRC/JMC/NC/DU
Summer 2012, Jasola, Delhi, I ndia

2. DESIGNING TARGETED
HEALTH
INTERVENTIONS
Global
Health
Affairs
Program,
University
of Denver

3. UNDERSTANDING THE •Who?
PIECES OF THE HEALTH •What?
•When?
PUZZLE •Where?
•Why?
•How?

4. Who:
GRC
JMC NC

5. ANTENATAL CLINICS AT THE GRC
From July 2011 to April 2012, 60 women have visited the
GRC for the ANC clinics
Basic Demographics
Age: 17 - 40 years (average 26)
Weight: 28 – 70 Kg (48 Kg)
Age at marriage: 16 – 26 (18)
Age when had 1st child: 16 – 24 (19)
Number of births: 0 – 8 (3)
Where and How

6. KNOWN HEALTH ISSUES
 Pregnancy and delivery:
 Multiparity
 Lack of spacing between births
 Anemia
 Urinary infections
 Other Issues:
 Nutritious food during pregnancy and after childbirth
 Appropiate rest after childbirth
 Almost all of them complain about back and body pain
What and Why?

7. ENGAGING THE COMMUNITY
Focus groups With Mothers on Maternal and Child Health (MCH)
 Knowledge of health
issues
 Perception of
available health
services
 Ideal scenarios for
improved health:
 Services
 Education
 Technology

8. MOTHERS KNOW BEST
FOCUS GROUP RESULTS
1. Knowledge of health issues
• Symptoms: mild vs. severe conditions
• Ailments and treatment
• Seeking health attention
2. Perception of available health services
 Public vs. Private
 GRC and AWWs
3. Ideal scenarios for improved health
• Affordability
• Proximity
• Improved attention

9. - Dizziness Symptoms
- Weakness Baby cries Mild
- Very sleepy Severe
a lot
Dry lips and throat,
doesn’t drink milk,
Lack of dehydration, more
- Tough for appetite vomiting, silent
child to
survive
Stomach Thin
- Weakness
swells,
- Doesn’t
stomach
play
ache
anymore
- Pale and
yellowish More frequent
skin defecation, +10
times a day
Black and green poop
that scatters to legs, 2-4
times a day
Perceived Health Issues

10. CONVERSATIONS WITH GRC STAFF
Key Topics
 Challenges to current work
 Lessons learned from MCH Focus Groups
 Ideal Scenarios for improved institutional capacity
Follow-up Steps Taken
 Trainings on leading Focus Groups and facilitated
dialogue
 Next Steps for improved institutional capacity
 Foster relationships with AWWs
 Increased and improved health analysis
 Subsequent advocacy on a variety of health issues
 Designed and tested pilot technology solutions

11. PILOT TESTING
TECHNOLOGY
SOLUTIONS

12. CURRENT DATA MANAGEMENT
SYSTEMS
Largely Paper-based
Integrated with excel spreadsheets,
but often saved on different
computers.

13. DATA MANAGEMENT PROBLEMS
KEY THEMES
GRC
 Location issues: finding and following up with Mothers
and Children
 Difficulties in tracking mothers over time
 Greater demand for services than GRC can supply
JMC/NC
 Desire for long-term analysis of key health issues
 Difficulty in sharing information between organizations
(JMC, GRC, NC, DU).

14. CONSIDERING TECHNOLOGY SOLUTIONS
My wish Reality

15. Ideal Scenario
JMC, GRC, and NC will be able to track all pregnant
and young mothers in Jasola by location and over
time, and be able to share all information with each
other with ease.

16. A world of technology
?

17. PROS AND CONS OF MOBILE PHONES
Pros:
 Relatively cheap to use
 Many people have them
 SMS can be integrated into database systems
 Creates a two way communication flow
Cons:
 Fewer women use them than men in Jasola
 Often only one per family
 Low literacy rates make it difficult to use SMS,
as opposed to a voice-based system

18. ANOTHER LOOK AT DATA MANAGEMENT
PROBLEMS
GRC
 Location issues: finding and following up with Mothers
and Children
 Difficulties in tracking mothers over time
JMC/NC
 Desire for long-term analysis of key health issues
 Difficulty in sharing information between organizations
(JMC, GRC, NC, DU).

19. ANOTHER LOOK AT DATA MANAGEMENT
PROBLEMS
GRC
 Location issues: finding and following up with Mothers
and Children
 Difficulties in tracking mothers over time
JMC/NC
 Desire for long-term analysis of key health issues
 Difficulty in sharing information between organizations
(JMC, GRC, NC, DU).

20. Lets talk about maps….
Again…..

21. USING MAPS TO:
Resolve location issues by
Geographically tracking
mothers
Analyzing their health
problems over time
In a way that can be
shared between all groups

22. SAMPLE MATERNAL HEALTH
INDICATORS
Minimum
3 ANC
Initiation
of Safe
breast-
Pregnancy delivery
feeding
and 28
days post
delivery
Post
Immuni-
natal
zation checkups

23. MAPPING: FIRST STEPS
Multiple mapping
platforms examined
Region was mapped,
and combined with
trainings for GRC and
NC staff

24. THE ADVANTAGE OF COMMUNITY
BASED MAPPING
Our Map Googlemaps

25. Lets talk about layers

26. WHAT ARE LAYERS?

27. WHAT ARE LAYERS?

28. OUR LAYERS
 Level 1 - Base Layers
 Roads
 Water
 Schools
 Temples & Mosques
 Level 2 - Interactive Layers
 Clinics
 Anganwadi Workers
 Pharmacies
 Mothers

29. BASE LAYERS

30. INTERACTIVE LAYERS

31. Platform uses entirely free and open source
systems
1. Data shared and
stored on
googledocsand
googledrive
2. Base layer edited on Open Street
Map
3. Interactive layers
edited and
accessed on
Geocommons

32. FLOW CHART OF INFORMATION
ANC Clinic Indicators on
Indicators on
at GRC printed
Googledocs
forms
Indicators on
map
Advocacy Referral Analysis

33. Questions and General Discussion