Post authored by Sara Hollis, Impact Analyst. The snapshot above shows select Standard partners and details about their deployment.
It’s been over one year since the launch of our innovative Standard package, an application that supports people-centered workflows with case management and care coordination for patients over time. It works well with occasional connectivity, contains powerful analytics, can be supported with basic or smartphones, and can be used in multiple languages, including English, Hindi, Swahili, French, and Bahasa Indonesia. This toolkit was developed to enable organizations to deliver tried-and-tested mobile health use cases with minimal on-site support. Since our first Standard partner, Barefoot College in Rajasthan, India launched in late April 2017, we have welcomed twelve more Standard partners across six countries. This cohort ranges from smaller community-based-organizations with less than ten health workers to larger multi-site organizations with dozens of clinics across various districts.
The Standard package was launched with antenatal care coordination as the first available use case, allowing CHWs to register pregnant women in their area, receive task reminders for when ANC visits are needed, report on the women’s status during these visits, and record delivery details. Last month, we launched postnatal care (PNC) and immunization use cases as part of the package, which several current and new partners will begin using this summer.
As a data-driven organization, we are committed to actively using data available within and across health systems especially in the introduction of a new product such as the Standard package. A year after the Standard launch, we have witnessed significant activity across Standard partners, including: 3,616 registered women, 2,448 registered pregnancies, 2,470 confirmed antenatal care visits, and 1,164 delivery reports. The graphic below shows the breakdown of activities month over month. As partners move along in their deployment, a larger proportion of activities involve ANC Visit Confirmations and Deliveries, versus the heavier focus on people and pregnancy registrations in earlier months
Medic Mobile sets one primary indicator and 1-2 additional impact indicators for each of our priority use cases. For our ANC use case, our primary impact indicator is the percentage of women delivering in a health facility, while an additional impact indicator is the percentage of women with 4+ antenatal care visits during their pregnancy. To view early progress, we monitor the proportion of women that were registered for ANC in their first trimester, and what percentage of women have 1+, 2+ and 3+ ANC visits by the end of their second trimester. With consistent use of our Standard ANC tool by CHWs, we hope to drive improvements in these indicators.
The graphic above shows the percentage of women with 1+, 2+ or 3+ visits by the end of their second trimester, across all ANC deployments by month of deployment. Evidenced by the green line, up to 82% of all pregnancies have reached 1 or more visit by the end of their second trimester, while 36% have received 2 visits, and 18% have received 3. These percentages have steadily increased since initial project launch, where only 5% of pregnancies had more than one visit at second trimester by the end of the second month of deployment.
The graphic above shows the percentage of women with 1+ or 4+ visits during their entire ANC period by month of deployment. The percentage of women receiving the recommended 4+ visits has increased over time, but still remains lower than expected. Difficulties include identifying pregnancies early: many women are not identified by a CHW until later in their pregnancy. In addition, some women that are initially registered for ANC are not frequently followed up with, due to the woman moving away or the CHW losing track. Increasing the percentage of women receiving full coverage of ANC services demonstrates not only initiation of ANC but continuity of care throughout the pregnancy.
The graphic above shows the facility-based delivery rates across all ANC projects, since month of deployment. While the overall facility-based delivery rate started out close to 50% during the first month of Medic Mobile deployment, it has reached close to 90% by month five. Across all partners, 97% of women were delivering in a facility by month eleven.
It is exciting to see these metrics visibly improving over the course of project deployment for our Standard partners, and we look forward to continuing to monitoring these across more partners and use cases in the coming months. Stay tuned for more insights about the Standard package in coming weeks, and visit this page if you're interested in deploying!