Country of Operation
Target income level
- Bottom 20%
- Lower-middle income (20-40%)
- Middle-income (40-60%)
- Maternal, newborn and child health
- Primary care
SummaryBRAC Manoshi is a five year urban maternal, neonatal and child health programme that equips Shastho Karmi (SK) health workers with mobile phone-based data collection software, allowing them to more efficiently record and report vital patient information in a simple and standardized format.
The programme is designed to significantly improve maternal, neonatal and child health in the six major cities of Bangladesh through the following specific objectives: - Build a cost-effective mobile-phone based solution for data collection and remote health risk screening for maternal, neonatal and child health - Develop an efficient and automated scheduling system for health workers - Test an automated risk assessment system on the basis of pre-defined algorithm - Develop a tool for real-time report generation and monitoring.
Key program components
BRAC Manoshi envisages improvements in health status of poor urban mothers, newborns and children by bringing healthcare services at their doorstep through our frontline Community Health Workers (CHWs). The Shasthya Shebikas (SS) and Shasthya Kormis (SK) provide antenatal and postnatal care, essential newborn care (ENC) and child health care.
Through behaviour change communication interventions SKs motivate, educate and prepare expectant mothers for childbirth, highlighting an array of health issues including maternal and neonatal danger signs, maternal and neonatal nutrition and so on.
BRAC Delivery Centres are established within slums to provide intra-natal care to mothers and immediate care to newborns. Emergency obstetric, neonatal and child health complications are referred to the hospital through an established referral system by strengthening linkages, and ensuring continuum of care.
Community is connected with health facilities via an innovative mobile phone based referral system. After expanding to additional city corporations in 2012, Manoshi is currently being implemented in eight city corporations.
After extensive studies of the Bangladeshi Rural Advancement Committee's (BRAC) health services for mothers, neonates and children in rural and urban areas (MNCH and Manoshi, respectively), ClickDiagnostics has developed a mobile phone-based solution for streamlining BRAC's data collection procedures in Manoshi, enabling BRAC to take a more pro-active approach in reaching women in urban slums.
ClickDiagnostics proposed a simple and yet powerful mechanism for data collection, which would eliminate most, if not all, of the bottlenecks faced by the Manoshi programme. Under this system, health workers (Shastho Karmi-SK) are equipped with a mobile-based data collection software which enables them to collect vital patient information in a simple one-by-one question format with multiple choice answers. The data is viewable on a secure web page where the doctor is able to provide feedback based on the patient's information directly to the SK's mobile phone. An automated risk assessment algorithm analyzes each patient's data and categorize the patient into a risk category based on predefined criteria.
Based on pre-set rules, the server can also generate automatic alerts to different tiers of the Manoshi personnel. Through behaviour change communication interventions, SKs motivate, educate and prepare expectant mothers for childbirth, highlighting an array of health issues including maternal and neonatal danger signs, maternal and neonatal nutrition and so on.
The mHealth system also generates automatic work schedules for SKs, prioritizing higher risk patients. Supervisors are able to monitor the data sent by SKs cumulatively and individually in an intuitive but powerful graphical reporting and monitoring tool.
SMS alerts are generated to supervisors for workers missing their daily/weekly/monthly targets. In this way, it is hoped that the system will become more efficient. Nine SKs in 3 branches of Dhaka comprised the pilot intervention area, covering 18,000 households and approximately 2,000 pregnant women. Initial reviews of the pilot program have shown some positive results.
The mobile equipped health workers were able to identify 86% of all pregnancies in the selected areas, 81% of which were provided with ante natal care and 80% received post natal care on at least three occasions. In an attempt to increase delivery attended by specially trained personnel, several delivery centres or birthing huts were established. Approximately 44% of the pregnant women identified by the programme used the BRAC Delivery Centres.
In 2011, BRAC Manoshi also tested out an emergency support system, which included the establishment of an emergency hotline, the integration of medical records, and software for emergency services in order to connect emergency calls to ambulance and hospital system which would encourage fast referrals to ambulances and health clinics.