ARMMAN

Context

Although India has improved its Maternal and Child Health (MNCH) indicators over the past decade, a lot still needs to be done to achieve the SDGs. On average, there are ~900,000 children under 5 deaths and ~30,000 maternal deaths every year in India. The majority of these deaths are due to preventable or treatable causes. Poor performance of maternal and child health indicators can also be attributed to socio-economic factors such as a patriarchal and superstitious society with women often not being the primary decision-makers for their own or their baby’s health.   

Last-mile government Community Health Workers (CHWs, ASHA workers) are the first point of contact within the public healthcare system in India. However, they are usually over-burdened, under-supported and ill-equipped, resulting in poor quality of care.

There lies a huge potential for improving maternal and child health outcomes through preventive care, improved access to accurate health information and better support for government CHWs (ASHA workers) in India. 

Solution

Founded in 2008, ARMMAN works towards ensuring safe pregnancies, healthy babies, and thriving young families. The organization works in low-income (rural and urban) communities where:

1. Women and their families do not have access to health information to make informed decisions
2. Women do not have the agency to make decisions for their own or their baby’s health
3. Government CHWs and midwives are not adequately trained to support women well.

In 2019, ARMMAN entered into a collaboration with India’s Ministry of Health & Family Welfare (MoHFW) as its implementation partner for two of its flagship mHealth programs (Kilkari and Mobile Academy) to improve maternal and child health outcomes. Kilkari is the largest maternal and child mHealth program in the world. Since inception, programs implemented by ARMMAN have reached ~18m pregnant women and their families and trained ~160,000 Community Health Workers (CHWs) in India.

The organization uses a ‘tech plus touch’ model that leverages high mobile phone penetration and existing health infrastructure to deploy tech-enabled, cost-effective, evidence-based and highly scalable mHealth solutions to:

1. Increase access to preventive health information to pregnant women and their families through free, pre-recorded voice calls targeted to a women’s stage of pregnancy or infant’s age via:
   1. mMitra (own program)
   2. Kilkari (government partnership)
2. Train and build the capacity of CHWs (ASHA workers), for improved diagnoses, referral and care through a free, refresher training course using pre-recorded voice calls via:
   1. Mobile Academy (government partnership)

Impact depth

ARMMAN’s impact has been validated through multiple research studies including a randomized controlled trial; select KPI’s showcasing proven program adherence & effectiveness:

SDG 3.1, 3.2: Focus on maternal and child health to reduce maternal, infant, neonatal mortality

• 89% of women went for 4 or more Antenatal Care (ANC) visits in the 3rd trimester of pregnancy
• 33% increase in the proportion of infants under 6 months who were exclusively breastfed
• 22.5% increase in the proportion of infants who tripled their birth weight at the end of 1 year

SDG 3.c: Increase the recruitment, development, training, and retention of the health workforce

• 100% of CHWs trained felt improvement in their capacity to support women & their families
• Significant increase in CHWs’ (ASHA workers) knowledge of critical health behaviors, confidence & social standing in the community

* Since inception of programs, includes pregnant women and families and CHWs reached prior to ARMMAN taking over management of the government’s two mHealth programs (Kilkari and Mobile Academy) in 2019