IEEE Technology and Society Magazine - Fall 2013 - 33

the major occupation of the community. Common prevailing complaints are gastrointestinal, fever,
obstetrics and gynecology related,
and fall related (musculoskeletal).
Center-K services the community
through various health programs
such as family planning, RCH,
immunization, water disinfection,
iodine deficiency disorder control,
blindness control, tuberculosis
control, leprosy elimination, and
water-borne and communicable
disease control programs.
for mHEALTH-PHC, our focus
is on the RCH program, which
focuses on preventive, promotional,
and curative mother and child
health services. The midwife and
the social health activist conduct
home visits to deliver antenatal and
postnatal services to the mothers.
They also record the health data of
children below the age of five years.

Challenges for Primary
Healthcare Centers and
the Community
Although government intends to
provide the primary healthcare to
the rural community through the
National Rural Health Mission,
the ability to reach the community and deliver end user benefits is
restricted due to challenges faced
both by the community and the
Centers. We list some of them in
general and for RCH specifically.
■ Lack
of transport and
approach roads makes it difficult for pregnant women to
reach a nearby Center or rural
hospital;
■ When
complications arise,
there is no easy way for a
midwife to seek advice from
Center doctors. Similarly for
Center doctors, there is no
easy and effective way for
them to consult experts at the
city hospitals;
■ The
secondary status of
women in the community,
preferences for a male child,
short birth intervals, inadequate immunization coverage,

socio-cultural practices, and
poverty are other compounding factors adversely affecting
maternal and child health;
■ The health information system
in the Sub-center is being operated manually. This situation
causes inadvertent delays in
transmitting the data recorded
by the social health activist and
the midwife to the Center, often
located 5-10 km away from the
Sub-center. As a consequence,
there are feedback delays from
the Center, and then mothers are deprived of prompt
advice and intervention. The
manual recording of data is
also subject to human error,
unfavorably influencing health
interventions.
■ Capacity building for health
workers in terms of data management is lacking and health
records are not interpreted
epidemiologically. Thus, until
feedback is received from
the Center, the interventions
may not be consistent or even
appropriate; and
■ for typical Indian rural conditions, there are other challenges such as good approach
roads, safe drinking water,
uninterrupted power supply.
and availability of educational
facilities for staff families to
stay in villages. As a result, the
posts of trained doctors remain
vacant in many Centers.
After studying the above challenges, we designed and developed
the mHEALTH-PHC solution [9].
for healthcare management and
monitoring, there is a need for information flow from a patient at the
village level to a doctor at a Center
level. These need to be monitored
simultaneously at different levels
of the management process. In the
following section, we describe a
mobile phone based informatic tool
called mHEALTH-PHC, which
facilitates the required information
flow. This tool addresses the challenges identified above.

IEEE TECHNOLOGY AND SOCIETY MAGAZINE

fALL 2013

mHEALTH-PHC: Mobile
Phone-Based ICT Tool
The ICT tool mHEALTH-PHC
was first showcased in the e-Health
pavilion at the World Telecom
Conference 2009 in Geneva [10].
This tool helps to meet the healthcare needs of the community and
to overcome the challenges faced
at the Center by connecting the
rural patient to the Medical Officer
through the midwife or the social
health activist. By establishing
efficient communication between
the social health activist, midwife,
and Medical Officer, mHEALTHPHC expands the Center outreach;
thus facilitating timely, quality
healthcare to the community under
consideration. As mentioned above,
for the mHEALTH-PHC application, we are currently focused on
the RCH program.

mHEALTH-PHC Components
To connect the remote patient to the
doctor, mHEALTH-PHC has five
major components that together
use various technologies including mobile Internet, Interactive
Voice Response (IVR), Indian language font rendering, and usability
frameworks:
1) Client software in the local
language on a mobile phone
used at the patient's end;
2) Servers in the secured data
center;
3) A doctor's console, which is
viewed by a doctor/expert to
suggest treatment/tests and
prescribe medicines to the
patients;
4) An IVR application to record
the information and observations; and
5) A reporting console to view
various reports related to rural
health in consolidated manner.
The mHEALTH-PHC design
is based on the existing government healthcare infrastructure and
is influenced by rural community requirements and challenges.
The mHEALTH-PHC platform is
based on the patented "mKRISHI"
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Table of Contents for the Digital Edition of IEEE Technology and Society Magazine - Fall 2013