Three government female health-workers are responsible to deliver health and nutrition services in India’s villages. Each village has an Auxiliary Nurse Midwife (ANM), the ASHA (Accredited Social Health Activist) and Anganwadi Worker (AWW). Each has distinct, but related roles, and they work in the same villages. However, they have different reporting structures and protocols, and all too often, they do not collaborate enough.
The solution brings the three village frontline health workers (FLWs) together on a common data-sharing and problem-solving platform. This enables them to better identify and prioritize high-risk beneficiaries, followed by proper management and treatment.
Frontline workers do not have a shared understanding of the geography and location of households. There are few opportunities to share information and learn from each other
They have different methods to identify and track beneficiaries. AWWs organize people by families, ASHAs use households and ANMs work on a record of eligible couples (married couples in the age group 15-49). This results in service or program gaps.
Beneficiaries are not prioritized in terms of case urgency or risk. They are approached in a prescribed linear sequence
Workers are not equipped to handle community resistance. They have few tools and little training.
Solution: The AAA Way
1. A common database
AAA work together to create a village map, synchronising household and family coverage. On these maps, they number houses and affix coloured bindis to denote various categories of beneficiaries and dynamically track them, prioritising those at highest risk.
Now, village health and nutrition information is available at a glance. AAA also involve the community in validating the maps. This raises community's interest in village health issues and the AAA's standing in society.
ASHA workers visit ten houses every day. Previously, they did it in a linear manner (house one to ten on day one, eleven to twenty on day two and so on). The AAA platform helps them plan visits based on beneficiary needs using a simple algorithm. They can now deliver care when and where it is most required.
One specific day every month (varies state-wise), a Village Health and Nutrition Day (VHND) is organised in every village. Through the AAA platform, the three workers have a formal meeting. Here, they review each other's work and data, plan for the next month and close with a peer learning session where they educate each other on technical and administrative matters.
frontline workers trained to use data and identify risk
health workers use our household visit calendar tool
villages mapped to accurately identify key beneficiaries
more high-risk pregnant women/malnourished children identified
Figures are based on estimates using publicly available sources, and from Antara Foundation’s monitoring system in Rajasthan
Stories from the field
Watch the AAA Platform's impact along its theory of change: Enhance enumeration, enable prioritization, improve knowledge and ensure joint-work