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Program JAYA

Improving the efficiency and efficacy of frontline workers for complete immunization in peri-urban & rural areas of India.

Photo of Devina Kothari
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

Zuan aims to build an accurate National Immunization Health Database using GIS Technology to aid better beneficiary data collection by frontline workers in peri-urban & rural areas of India and aid data analysis and micro-planning by supervisors.

Explain the idea (less than 2,000 characters)

Program JAYA is a digitally powered program that uses GIS Technology for better immunization data collection and analytics while collecting data on denominator/beneficiary and providing analytics helping increase the efficiency of ASHAs/mobilisers. JAYA leverages the rapidly digitizing Indian landscape and is designed keeping in mind the low-tech familiarity and education levels of ASHAs(Accredited Social Health Activists). JAYA can be downloaded from the Android App store and can even be used on an entry-level smartphone. JAYA also helps by generating data on denominator (total number of beneficiaries of the immunization program) and tracks these beneficiaries to build an accurate national immunization health database. This database can be used by ASHAs, ANM(Auxiliary Nurse Midwifery) and other government bodies get real-time data & insights on lapsers (drop-outs and left-outs) that need urgent attention, helping in better micro planning and coverage. JAYA brings every stakeholder (beneficiaries, supervisors, healthcare providers and facilities) in the immunization chain onto one singular platform. It helps in real time monitoring through customizable dashboards for every supervisor in the pyramid. Background: In India, mothers and children below the poverty line are administered vaccines by the government at no additional cost. Frontline workers/ASHAs need to get these beneficiaries to the vaccine session site. Since these mothers are very poor they do not own a mobile or devices that automatically remind them for vaccines, the frontline workers are their point of contact. Another reason for empowering frontline workers is that they bust the myths associated with vaccines and convince beneficiaries to get immunized. Sometimes multiple sessions of counselling are required before the mother finally allows the child to get vaccinated. Program JAYA has been designed building upon these common practices and empowering the frontline workers.

Which part(s) of the world does this idea target?

  • Southern Asia

Geographic Focus (less than 250 Characters)

Program JAYA targets peri-urban and rural areas of India (Southern Asia) impacting pregnant mothers and children up to 5years from the below-poverty-line population.

Who are your end users and how well do you know them? (750 characters)

Following are the challenges of end-users that Program JAYA addresses and solves for: 1. ASHA workers (Accredited Social Health Activists) in India These are the frontline workers who meet the immunization program beneficiaries on a regular basis. Challenges: A. Inefficiencies in tracking which vaccine to administer to whom and when. B. Lack of data on where are the dropouts and left outs C. Challenges in tracking the migration of beneficiaries. 2. Supervisors These are the executives who micro-plan the program. Challenges: A. Lack of data on where (location) and what is the total denominator under surveillance. B. Inaccurate data for the last mile program manager to analyze the program on real-time for better micro-planning.

How is the idea unique? (750 Characters)

Program JAYA has been designed after a thorough research phase and continuous validation of various features, functions and usability from all stakeholders who shall be using Program JAYA. Special attention has been paid to weave-in the socio-cultural and infrastructure limitations of the areas of operation into the design of the digital platform. This has increased the local acceptance of the platform by the frontline workers. Background: There is an existing pattern of data collection which standardized across India. Program JAYA is built considering the existing system and its smooth integration. All frontline workers in the current scenario are trained prior to joining their duties. This helps to maintain standardisation in activities

Idea Proposal Stage (Select 1)

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

How many months are required for the project idea? (140 characters)

It shall take us 7 months to implement Phase 1 and 12 months for Phase 2.

Organization Name (less than 140 characters)

Zuan Design Labs LLP

Type of Submitter

  • We are a For-Profit Startup or Startup Social Enterprise

Organizational Characteristics

  • Female-led organization
  • Indigenous-led organization
  • Youth-led organization

Organization Location (less than 140 Characters)

City: Rajkot State: Gujarat Country: India

What is the current scale of your organization’s work?

  • National (expansive reach within one country)

Website URL

http://zuan.in/

Tell us more about your organization/company (1-2 sentences)

At Zuan Design Labs LLP, we specialise in problem-solving techniques and come up with innovative solutions across verticals like social impact, healthcare, agriculture, e-commerce, etc. We cross-pollinate learnings from various verticals and make the solution more relevant to their target audiences.

Who will work alongside your organization in the project idea? (750 characters)

We shall be working closely with local ASHA workers in every region that JAYA will be implemented to incorporate unique hyper-local features to ensure the best efficacy. ITSU (Immunization Technical Support Unit, India) shall aid in rolling out JAYA across India. The Bill and Melinda Gates Foundation would help in fine-tuning the features of micro-planning to aid the last mile program manager as well.

How many people are on your team?

5

Tell us more about you and your team

We are an enthusiastic bunch of doers who believe in bringing about change. Our core team comprises of Devina Kothari (User Research and Analysis, User Experience and Interface Design, Innovation Strategies, Design Management, Product Design, Manufacturing and Packaging.), Gaurav Nabh (Brand Strategy, Marketing Campaigns, Digital Performance Marketing, Mobile Marketing, E-commerce, Digital Strategy, Brand Launches, P&L Accountability), Akhil Kishore (Strategic Planning & Execution of Plans; Fund Raising; P&L Accountability; Government Regulations & Relations, Contract Negotiations & Strategic Alliances), Vishal Malvania (Implementing Big Data strategy for near real-time or batch analysis on cloud services, IoT, connecting high-density connected field devices to centralized device gateway for remote command pattern and cloud services) and Maulik Kothari (Operations, Administration and Finance).

Overview of How Your Concept Has Evolved (5-6 sentences):

It has been a wonderful journey evolving and nurturing the concept into a robust proposal. The stakeholder feedbacks were extremely helpful and validated our hypothesis giving us more confidence to go ahead. While validating the business model with the beneficiaries, we realised that our hypothesis that the below-poverty-line beneficiaries may not spare more than INR 25/- for the services offered by JAYA, stood negated and we were happy to know that they were willing to pay up to INR 75/- for the entire immunization regime as they believed that it is ultimately cheaper than getting treatment against the disease contracted otherwise. It has been a wonderful journey interacting with the community experts and the OpenIDEO team.

Viability (3-4 sentences and activity upload):

https://drive.google.com/file/d/1SwUmYkhGOySqJuJQDq_z1pQtpFmfg9Oj/view?usp=sharing .......In case the attached image is not readable, we request the viewers to copy+paste the above URL to open the Business Model Canvas.

Feasibility (3-4 sentences):

The model is tested to be feasible for the following reasons: 1. The beneficiaries were willing to spend up to INR 75/- for handholding during the entire immunization regime as they realised that the above cost is significantly less as compared to the one incurred if infected by tuberculosis, pneumonia, etc. 2. The ASHAs/mobilisers were able to use the proof of concept App on their phone and plot households and even follow the route schedule easily without any mentoring. 3. The supervisors were very happy to see the decision-making dashboards and the flexibility it offered to them.

Desirability (3-4 sentences and activity upload):

We understood the various personas of our primary stakeholder (beneficiaries) and understood their respective challenges (beneficiaries, caregivers, ASHAs/mobilisers, supervisors) and plot their insights and opportunities. These opportunities were translated into various features and functions of JAYA's platform to address the unmet needs of consumers. We have created a document that details these insights and opportunities gathered from various stakeholders' feedback and the annexure that showcases user experience and interface for various use cases. We could not upload this .pdf, hence sharing the link below: ....... https://drive.google.com/file/d/16OSddratb7UtoBQHWP4e8WmXHcFjZreq/view?usp=sharing

Community Focus (2-3 sentences):

In spite of the government spending upwards of INR 7,000 crores, through Mission IndraDhanush the immunization coverage has not increased by more than 8% in the peri-urban areas which is of great concern, especially for the coming generations and the government. Many children drop-out of the regime after birth-dose and often do not live up to the age of 5. The caregivers rely on ASHAs/mobilisers to help them get awareness and get the right vaccines, but the ASHAs need to be empowered to increase their efficiency and efficacy as they also cater to 42 other government programs as well.

Community Impact (2-3 sentences):

Upon successful implementation of Program JAYA, we shall be able to help build an accurate national immunization health database. This database will help in better micro planning and extrapolating the national household database for rural and peri-urban areas to help achieve better coverage and efficacy in similar related healthcare services that rely on such hyper-local databases. After the initial support from Gates Foundation, the Ministry of Health & Family Welfare will be rolling out the program in Gujarat, India. The program shall sustain itself by a SAAS model as described in the BMC.

22 comments

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Photo of Kuq Ya
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Photo of Isaac Jumba
Team

Hi Devina Kothari ,
Great to read your idea. I especially like the conversation and questions asked on the comment section.

I wonder if there Temba Vicent 's idea of MAMA CHANJO: Key Immunization mothers  could potentially test your product in their context?

Photo of Devina Kothari
Team

Hello Isaac Jumba ,
Thank you for your appreciation. Feel humbled.

It would be great to explore opportunities to collaborate and test the product. Having said that, I would prefer to first conduct a small User research project in the newly proposed region to identify the unmet needs which can be addressed by Program JAYA and translate the same into unique features of the solution which is customised for that particular region to increase the program's efficacy.
Temba Vicent We may connect and discuss this further.

Best Wishes,

Photo of Manisha Laroia
Team

I am delighted by the details of the system that you highlighted in the conversation with @Temba Vicent below.
I would recommend adding those details in some sort of a service model or user experience map which can be uploaded as an attachment.
Please make sure you have added all the information you have to the submission before the challenge deadline.

As Community Fellows Isaac Jumba and I are happy to help if you have any questions or need any resources. Please feel free to tag us or message.

Since you have a prototype ready we would encourage you to also look at our other vaccine challenge and share your innovation there also. It would make a good fit.
Please have a look:
https://www.openideo.com/challenge-briefs/infuse-urban-immunization

Photo of Devina Kothari
Team

Thank you for your suggestion. I have added the details in the paragraphs and updated the document.
We shall be applying to the Gavi-INFUSE challenge as well.
Thank you Manisha Laroia and @IssacJumba for extending help. Truly appreciate it.

Best Wishes,

Photo of Manisha Laroia
Team

Hey Devina Kothari 
So great to see your idea in the challenge! I really appreciate the detailed understanding of the user and the context that you have gathered.

It would be interesting to see how you could make the caregivers (i.e. immediate family feature in the centre of the story of the idea.
Also, I am curious to know if Anganvadis can be brought in as partners and how could you mold this idea for a countries of East Africa?

Since you have these nice visuals and maps, it would be very helpful in terms of presentation if you could split the first long image you have uploaded into smaller images so that viewers can read about your idea in depth.

Photo of Devina Kothari
Team

Hello Manisha Laroia 

Thank you for your appreciation.

Immediate family feature in the centre of the story of the idea: Although the digital platform is designed to be used by the ASHA/frontline workers, the caregivers are at the core of it as they benefit from the entire system. In India, the immunization services for the rural and peri-urban areas are disseminated through a standardised singular channel involving ASHAs to mobilise beneficiaries for the immunization session and also maintain records for the same for continuous reference and planning, it seems more relevant to empower them so that they can, in turn, provide more relevant information to the caregivers. For example, a caregiver may not have access to videos showcasing the potential side effects of a DTP vaccine, following which she might not agree for the next dose leading to a 'drop-out'. Program JAYA facilitates such visual aid (video and images) that help ASHAs to educate caregivers through credible sources prior to the session. This further helps build faith in the ASHA workers and reduces reluctance towards immunization. There are many such features that are specially designed to aid caregivers but via the ASHAs so that there are standardization and authenticity in the communication pattern, often cognitive abilities of ASHAs are higher than the caregiver and ability to adhere to the regime is higher when there is a local familiar coach (ASHA). Anganvadis: In many areas, ASHAs mobilise/get beneficiaries to Anganvadis for immunization. East Africa: I need to study further how Program JAYA can be finetuned for specific countries by building on their existing user journeys. Regional customisation will make it richer and easier to adopt. Will investigate this. It will be great if you pitch in your target countries enabling me to investigate in the right direction. Presentation: Thank you for bringing it to my notice. I have split the long image into 3 and is more readable now.I hope I address your queries. Feel free to revert for further clarifications.

Best Wishes,

Photo of Ashley Tillman
Team

Hi Devina Kothari great to have you in the Challenge!

Exciting to see such an ambitious goal of an improved National Immunization Health Database, can you share a bit more about how you do/would approach collaboration with government and other implementing partners both within your design process and as you think of scaling this solution?

Also would love to learn a little bit more about why you think this type of solution hasn't been effective before and how you are addressing those issues?

Manisha Laroia any other ideas or questions?

Looking forward to learning more!

Photo of Devina Kothari
Team

Hello Ashley Tillman 

Thank you for your generous appreciation.

Collaboration and implementation:
We shall partner with Bill and Melinda Gates Foundation: INDIA which advises the Indian government on strategic innovative initiatives towards improving the efficiency and efficacy of immunization programs within the region. With their help in fine-tuning, especially with respect to the dashboards that help in micro-planning for the last mile supervisor, we shall roll out a pilot in their suggested region with the help of ITSU (Immunization Technical Support Unit) and jointly monitor the pilot. A set of final features and functionality shall be wired during and after the pilot making it ready for being rolled out in the rest of India and to start collecting data and generating actionable insights for the supervisors.

Why ProgramJAYA now and not before?
The tech infrastructure has taken a giant leap in India especially with the advent of JIO and internet access hubs even at village levels (penetration of Google's initiative: 'Internet Saathi' is a good example how rural India is leveraging the internet). This is the apt time to build a digital platform that is fed by first-hand and verified information at every coordinate under surveillance. This will give us a competitive advantage over future private sector platforms and also helps Program JAYA to feed in its data into ANMOL (ANM-Online, a government initiative that empowers ANMs but not ASHAs) thereby enriching the ecosystem.
We are positioning JAYA as ASHA's personal assistance rather than automation that might one day replace them. The user experience and interface have been designed keeping in mind the low-tech familiarity and use of lesser sophisticated mobiles. All frontline workers 'want' an assistant. Secondly, the women in rural and peri-urban areas feel valuable in the chain when such tools are made available to them which increase their efficiency and efficacy as they get remunerated based on the completion of an immunization regime for every beneficiary. Clarity on their remuneration often motivates them to work harder.

I hope I have addressed your queries. Feel free to reach out for more clarifications.

Best wishes,

Photo of Riddhi Shah
Team

Congratulations Devina and the team. As expected... purposeful and proud attempt! Your initiative will be very helpful to the needy.

Photo of Devina Kothari
Team

Thank you very much Riddhi. Look forward to the opportunity.

Photo of Saunil Malvania
Team

Great initiative. Rural and the most deserving population will benefit with optimum utilization of resources.

Photo of Devina Kothari
Team

Thank you very much for your generous appreciation. Your best wishes will help us propel ahead.

Photo of Temba Vicent
Team

Hello Devina,
Thank you for the positive idea. I am interested in data which you will collect, how that data empower mothers themselves to access immunization services? Kindly is it possible to share the feedback of your small tests regards on how caregivers access immunization services in your area?

Thank you

Photo of Devina Kothari
Team

Hello Temba,

Thank you for your generous appreciation.
In India, frontline mobilizers personally meet mothers and get them to immunization sessions. The data collected by 'Program JAYA' empowers these mobilizers to ensure that no pregnant mother or child is left out. Due to certain socio-cultural norms in most communities of India, many mothers migrate to a different location (her parents'home) to deliver the child and return to their own home after a few months. This pattern drops them out from the regular immunization regime. The data connect via 'Program JAYA' plots this migration and ensures that even in the above mentioned situation the mother and/or child does not miss out on any vaccine irrespective of their migration. This data also helps in making available consumables and vaccines based on the actual need of that particular location.

Hope my response is addresses your query. Feel free to reach out for further clarifications.

Best Wishes,

Photo of Temba Vicent
Team

Hi Devina,

Thank you very much for the quickly response.Good to see you bridge the gap between the mobilizers and mothers in the migration context.This is a great new way of thinking about how to fix the families cultural Norms which community valued.Yes some time it may happen that you may have a good technologies to fix out the problems but its acceptance is very much challenging.Is mothers aware about the solution which you talking about? If yes how about its acceptance to them in general? Since your talking a lot on the mobilizers side how about mother's side is there any more information to share? How about the test which you mentioned, Please respond to the second question above. How do you consider the quality of data since it may come from multiple health facilities as you mentioned with different vaccinators? Is there any challenges for this? Thank you.

Photo of Devina Kothari
Team

Hello Temba,

Thank you for appreciating our efforts. The acceptance of the system is very high. In India, mothers and children below poverty line are administered vaccines by the government at no additional cost. Frontline workers need to get these beneficiaries to the vaccine session site. Since these mothers are very poor they do not own a mobile or devices that automatically remind them for vaccines, the frontline workers are their point of contact. Another reason for empowering frontline workers is that they bust the myths associated with vaccines and convince beneficiaries to get immunized. Sometimes multiple sessions of counseling are required before the mother finally allows the child to get vaccinated. Program JAYA has been designed building upon these common practices and empowering the frontline workers. The usability test amongst the frontline workers and it's impact on the beneficiaries is positive and welcoming.
There is an existing pattern of data collection which standardized across India. Program JAYA is build considering the existing system and its smooth integration. All frontline workers in the current scenario are trained prior to joining their duties. This helps to maintain standardisation in activities and even data collection.

Hope I answer all your queries. Feel free to reach out for further clarifications.

Best wishes,