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"Swasthya Sakhi (Health Buddy)" - an app-based platform and wearable data storage bangle for effective antenatal care in rural villages

A mobile solution that joins innovative technology with cultural tradition to ease the process of registering and monitoring pregnancy

Photo of Monalisa Padhee

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In no more than 3 sentences, please tell us who your idea is designed for and how it reimagines the new life experience.

Our service affects health workers monitoring expecting mothers in rural communities. Paper-based records complicate health workers ability to organize information and track each patient, negatively influencing the quality of care. We introduce an app for digital enrollment and data storage which physically links the record to the patient via a wearable bangle. Information can then be shared readily and available to a network of healthcare providers in case of migration of nearby villages

Health workers, who should aptly be called health heroes, are saviors for many pregnant women in areas with very limited access to proper health care. They are responsible for ensuring that women are immunized and undergo all diagnostic tests to monitor general health and flag high risk cases in a timely manner, saving both mother and the baby from preventable illness. Extremely limited resource settings further complicate these responsibilities. Each patient requires a large volume of paperwork for enrollment and follow-up, which can be highly time consuming and difficult to organize. This prevents pregnant women from receiving antenatal  care at the right time. At the district level, where the central health team operates, significant time is invested in analyzing paper based records and following up with patients. Overall, this paper-based system negatively affects efficiency and quality of care.



 Evaluation of available resources and feedback from health workers has sparked ideas for a potential solution to these problems. Taking advantage of the mobile revolution and internet connectivity reaching to the most remote areas, we have directed designing our solutions using digital data collection and storage.



We have prototyped a two-piece system: a culturally accepted wearable device and a mobile software. At the point of enrollment, a health worker would be able to digitally register and issue a bangle to each patient. Each bangle is embedded with a QR code to uniquely identify each patient and provide a physically link to her medical records. Beyond enrollment, the app consolidates a patient’s complete diagnostic history and improves follow-up of antenatal visits through timely reminders. The reason for adding QR code stems from portability with any existing smart phone so as to make it affordable and replicable in low resource settings. 



A patient’s bangle is scanned with the health worker’s mobile device at the beginning of each visit to quickly access her personal information and complete history of records. As the health worker performs assessments, they may then enter new data into the mobile directly. At the end of the visit, the bangle is scanned again to update the stored data. All updated information is stored locally on the mobile until the health worker reaches an area of internet connectivity where it is pushed to a cloud-based server. The health data entered in the app could be accessed by the central health team who could then monitor the patients remotely.

This system would streamline the processes for enrolling new patients, monitoring data for making quick diagnoses, and  reminding health workers of upcoming antenatal visits. These improvements ensure that no women in a remote location is left behind in undergoing all required diagnostics and immunizations throughout the course of her pregnancy. We believe that our solution will revolutionize the healthcare provided to women in rural communities, but more than that, equip our health heroes with an effective tool. It is high time we invest in ensuring that these health heroes get the best possible innovative tools for saving lives!

At what stage is your idea?

  • Prototyping: I have done some small tests or experiments with prospective users to continue developing my idea.

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

We have designed and created a basic prototype consisting of a culturally accepted wooden bangle with embedded QR code and a mockup of the app flow. As the design has been built upon the needs and feedback from the health workers who are directly engaged with pregnant women in rural communities, we have assessed the prototype’s acceptability and effectiveness with the head health worker at Barefoot College and small group of pregnant women.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

This is a collaboration between an implementing NGO, Barefoot College, working with marginalized communities by empowering local women to become health workers and a biomedical engineering student from University of Wisconsin who brings in the technical expertise. We are actively seeking collaboration for app development centered around usage by a basic literate population in order to make it a truly human-centered design project.

Tell us about your work experience:

Monalisa works as program head of Women Wellness at Barefoot College . Hannah is a student of biomedical and also works at a digital health company. Prayag is the memeber of the R&D team of Barefoot College and has experience in digital tools. Alex (community protyper) works as a design engineer.

This idea emerged from...

  • A group brainstorm
  • An organization or company

Are you an expecting, new, or experienced mom?

  • no

Are you a healthcare practitioner?

  • no

Are you a current employee of UCB Pharmaceuticals or Sutter Health?

  • no

How would you describe this idea (in 2-3 sentences) while in an elevator with someone?

It is really unfortunate that even in 21st century, thousands of women in rural settings are unable to receive optimal antenatal care, largely due to health worker to patient ratio, high rates of migration, and further complicated by maintenance of extensive paper records. Swasthya Sakhi is a mobile solution that joins innovative use of technology with cultural tradition to ease the process of monitoring pregnancy.

What is the specific problem your idea is trying to solve? 1 sentence.

Maintenance of extensive paper records complicates the ability of frontline health workers to provide optimal antenatal care in settings with low health worker to patient ratio and high rates of migration.

How has your idea improved or evolved throughout the Refinement Phase?

Throughout the Refinement Phase, our back of the napkin sketch has been turned into a basic prototype and undergone preliminary user testing. We interacted with two mentors: Natalia has been helpful in providing perspectives on other digital data storage system, MVP approach for user testing, various collaboration we can embark on for the app development. Our community prototyper has been hugely supportive throughout the process; our regular brainstorming has resulted in refined designs for the wearable device and software interface suitable for our health workers with basic literacy. We have chosen to embed the bangle with a QR code so that the wearable can be scanned by any device with a camera and so the fabrication process can be kept simple and local. Although our health workers have smart phones, not many are equipped to work with NFC technology. We wanted to design a solution which uses their existing devices to (a) ensure smooth adoption of digital data entry and (b) avoid increasing the cost of our intervention by requiring new phones for this specific purpose. Additionally, QR codes can be printed as needed on Barefoot campus directly. We will be using Barefoot’s rural woodwork facility to create wooden bangles. The same machinists can embed the QR code and seal the enclosure with acrylic and adhesive. These are not only traditionally accepted, but also would be a product which will be symbolic of care that is being provided by the health workers to our pregnant women. This will also be a good starting point for conversation among rural women regarding proper antenatal care. We have created a prototype consisting of wireframes for the mobile app flow and a wearable bangle in Barefoot’s own woodwork facility and have tested with users (pregnant women, health workers, and facility managers of central health monitoring unit, Tilonia).The feedback have been positive and with some improvements, we are ready for a pilot for large scale user testing.

How do you plan to measure the impact of your idea?

We have conducted preliminary user testing of our prototype with a small group of women and the head health worker at Barefoot. Generally, both the patients and health worker see potential for positive impact from the Swasthya Sakhi system. With future iterations, we can compare look-up time required to find a patient’s record, number of patients seen in one day, diagnosis time, complete follow-up till delivery, number of antenatal care visits, and general patient satisfaction

What are your immediate next steps after the challenge?

The challenge has provided us a unique platform to collaborate with people of different expertise. We believe that we have formed a unique team which has members from frontline workers to people bringing in technical expertise and community prototyping. Going forward, we look to collaborate with a team of software developers and gather more feedback from health workers and patients. We will also seek funding for large scale piloting by applying to various grants or look for potential investors

How is your idea different or unique from what is currently on the market?

Current digital record storage systems are not designed with rural community in mind. Mostly the software are used by medical doctors with high levels of literacy and do not accommodate grassroots service providers. Our approach bridges tradition and technology to provide a low cost sustainable solution that is user friendly for a basic literate, compatible with any smart phone and a culturally accepted data storage which would result in widespread adoption and improved antenatal care
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Team (3)

Monalisa's profile
Hannah's profile
Prayag's profile
Prayag Ichangimath

Role added on team:

"Welcome to the team Prayag. Prayag will be giving his inputs on app development mainly on user interface design for a basic literate population. With his experience of working directly with communities, his inputs will be valuable be for our human centered design of the project. He will also be directly involved in direct user testing in rural Rajasthan, India and providing feedback for improvement."

Attachments (1)

App Flow V2.pdf

The app flow chart which will be translated into Hindi for our health worker

23 comments

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Photo of Monalisa Padhee
Team

Kevin Gibbons Thank you again for providing such insights again and suggesting opportunities for collaboration. We would definitely take the issue of Data privacy very seriously in our next iteration. We have initial thoughts of protecting the data using a login ID but will explore more with collaborating with technical experts. Epic system is very close where we Hannah and I are based at the moment. This is very helpful.

Photo of Kevin Gibbons
Team

Good luck Monalisa Padhee and team!

Photo of Kevin Gibbons
Team

Hey Monalisa Padhee and the Swasthya Sakhi team,

I emailed a contact that I have at Epic and gave him a brief description of your project to ask if there were any resources (grants or consulting) available for a project like yours. Here is his response:

"I'm not aware of any consulting that we do for outside organizations, but we do provide support for those trying to create their own APIs to integrate with Epic following our standards. I'm not sure how much this will help, since they are not using Epic, but it's possible that someone from the Apporchard team would be willing to help out. Take a look at the links below and see what you think. I'll also forward this along internally (and talk to my boss if he has ideas) and see if we have some folks that could help with this.

https://open.epic.com/
https://apporchard.epic.com/ "

Not sure how much that helps you guys at this stage, but Epic could be a good partner since they have a lot of resources and experience working with medical records. I think your project would also appeal to them and many other corporate donors. I'll follow up with my friend and see if he has heard anything or if he knows of a good contact person for you guys to reach out to.

Photo of Monalisa Padhee
Team

Kevin Gibbons  This is a huge help and we are definitely going to contact them and see opportunities of collaboration. Thank you once again !

Photo of Kevin Gibbons
Team

Hi Monalisa Padhee I sent you a message to your email address to connect you with an Epic employee who is interested in helping out. I got your email address from one of the OpenIDEO scheduling emails. Let me know if you didn't receive it. Good luck!

Photo of Monalisa Padhee
Team

Kevin Gibbons Thank you again for your support. We got in touch with the contact and will meet soon to discuss further.

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