Role of Information Technology in Policy Implementation of Maternal Health Benefits in India

Fifty thousand women died during childbirth in India in 2013, the highest total in the world; that is, one maternal death every 10 minutes. India and Nigeria account for almost one-third of total global maternal deaths. In pursuit of the Millennium Development Goals, the government of India directed efforts to improve maternal health and was able to reduce maternal mortality rate from 437 per 100,000 live births in 1990 to 140 per 100,000 in 2015, albeit missing the target of 109. Moreover, estimates for maternal morbidity are three to four times that of the mortality rates with even more pronounced regional disparities. Universal access to free public healthcare for maternal health has been a national goal since 2005, but its quality of service and utilization rate of maternal healthcare remains an elusive dream for many of the rural women even after a decade of substantial efforts. In a stark contrast, mobile technology has become more pervasive than the most basic infrastructure across the world. There are over 7 billion mobile phones subscriptions worldwide, but only 4.5 billion people have access to basic sanitation facilities, implying more people have access to mobile phones than toilets in the world, including India. The ubiquity of mobile phones can no longer be ignored. According to the 2011 census of India, 47 percent of the rural households owned mobile phones, and mobile phone network coverage spanned over 99 percent of the rural landscape, but only 31 percent of these rural households had a toilet. This exponential growth in mobile phone ownerships and adaptation has captured the imagination of academic scholars, public administration and the private sector to push for mobile based solutions and services in almost every aspect of public, social and personal life. M-governance has gained prominence too, aimed at improving service delivery, transparency, policy monitoring, public engagement, combatting corruption and poverty, especially in the developing world, leap-frogging poor-resource and low-income constraints. Today there is a mobile app for everything and the solution to any problem is a mobile app, including maternal health. However, amidst this optimism, it is surprising that the potential of mobile phones to improve social policy awareness is yet to be fully exploited. There are initiatives toward health literacy and mobile based cash transfers but few initiatives are geared toward improving awareness of social welfare policies, informing people about eligibility, enrollment and entitlements. Here lies the uniqueness of this research. Motivated to find solutions to actual policy implementation problems in practice, this research lies at the intersection of information communication technology, maternal health benefit policies and public management. In India, low maternal health benefits policy awareness imposes an administrative burden on rural women and leads to uptake of cash and public health service benefits. This research explores if mobile phones can be used as an effective medium to increase maternal health benefit awareness; thereby increasing the claiming of benefits. Using mixed methods of research, insights are drawn from a longitudinal case study in Melghat, a tribal belt of Amravati District in Maharashtra, India; a region that suffers from high maternal morbidity and high infant mortality rate. Forty-two percent of total childbirths take place in the home despite four different maternal benefit policies promoting institutional delivery and safe motherhood. In this dissertation, customized audio messages about maternal healthcare benefit policies were designed and broadcasted to 82 pregnant tribal women and followed up with qualitative interviews to examine any improvements in claiming of the policy benefits in 2013. The research provided an in-depth view of how information was disseminated through mobiles phones, and what factors and trade-offs, beyond information, were actually considered by the households in claiming the policy benefits. This research offers four contributions. First, it provides a deeper understanding of maternal health policies, how incentives work and the impact of conditions attached to these incentives, providing a plausible explanation for why the policies remain only partially effective. Second, in an era of m-governance, it illuminates the potential and limitations of the mobile phones in policy implementation and civic engagement, through a gendered lens. Third, it yields a caution to the technological optimistic use of mobile phones. By evaluating the causal mechanism of whether and how information awareness led to greater claiming of benefits, the findings revealed that information awareness alone was insufficient to improve claims when there were structural and systemic deficiencies in the policy design and management. Fourth, it advances the theory of administrative burden, by using mobile phones to reduce learning costs and by expanding the concepts of compliance costs and psychological costs, and highlights the relative interaction and trade-offs between components of administrative burden in an international context. The research concludes that although mobile phones have the potential to trigger demand for policy benefits and public engagement, and reduce learning cost, they are not the “silver bullet” because they cannot bypass the fundamental challenges of other administrative burdens, policy design deficiencies and bureaucratic processes

CDC activities and initiatives supporting the COVID-19 response and the President\u2019s plan for opening America up again

This document briefly summarizes CDC\u2019s initiatives, activities, and tools in support of the Whole-of-Government response to COVID-19.The principal objectives of COVID-19 surveillance are to monitor the spread and intensity of the pandemic, to enable contact tracing to slow transmission, and to identify disease clusters requiring special intervention. Secondary objectives include understanding the severity and spectrum of disease, identifying risk factors for and methods of preventing infection, and producing data essential for forecasting. In addition to tracking the disease itself, monitoring of healthcare capacity and essential supplies through the National Healthcare Safety Network (NHSN) is critical to ensure adequacy of care.Because no single system can capture all parameters of the pandemic, CDC has implemented multiple, complementary surveillance systems (Appendix A). Key systems are case-based reporting through the National Notifiable Diseases Surveillance System (NNDSS), laboratory-based surveillance, syndromic-surveillance data reported through the National Syndromic Surveillance Program (NSSP), and data on healthcare system capacity reported through the NHSN (Appendix B). Additional systems, such as COVID-Net, provide rich, publicly available information for meeting secondary objectives. CDC continues to explore emerging and experimental surveillance platforms with a critical eye toward proven utility.Control of the epidemic requires action at the individual, community, and population levels. CDC has provided state, tribal, local, and territorial health departments with extensive detailed guidance on contact tracing, infection control, and a wide range of other prevention and control topics. Recent models suggest that asymptomatic and pre-symptomatic transmission and delays in case recognition can greatly reduce the effectiveness of contact tracing. To enhance the speed and thus effectiveness of contact tracing, CDC is exploring technologic methods for instantaneous voluntary notification of contacts of confirmed cases.At the community level, recent events have shown the devastating effects that outbreaks can have among vulnerable populations, especially those in congregate settings such as nursing homes, prisons, and homeless shelters. Similarly, outbreaks in food production plants and other critical industries are crippling communities financially and threatening national food security. Rapid identification and response to these events is a CDC priority that can mitigate the immediate impact and provide critical insights needed to prevent future outbreaks in similar settings. CDC has developed extensive tools to assist states, counties, facilities, and industries in responding to and preventing these events (Appendix C).Widespread community mitigation combined with ongoing containment activities represents both an effective intervention for limiting the spread of COVID-19 and a serious threat to the economic well-being of the country and the world.Publication date from document properties.CDC-Activities-Initiatives-for-COVID-19-Response.pdfCDC Activities and Initiatives Supporting the COVID-19 Response and the President\u2019s Plan for Opening America Up Again -- Appendix A: Surveillance for COVID-19 -- Appendix B: Healthcare System Surveillance -- Appendix C: Guidance on Infection Control and Contact Tracing -- Appendix D: Guidance on Test Usage (Asymptomatic Populations and Serology).20207697Curren

CDC activities and initiatives supporting the COVID-19 response and the President\u2019s plan for opening America up again : May 2020

This document briefly summarizes CDC\u2019s initiatives, activities, and tools in support of the Whole-of-Government response to COVID-19.The principal objectives of COVID-19 surveillance are to monitor the spread and intensity of the pandemic, to enable contact tracing to slow transmission, and to identify disease clusters requiring special intervention. Secondary objectives include understanding the severity and spectrum of disease, identifying risk factors for and methods of preventing infection, and producing data essential for forecasting. In addition to tracking the disease itself, monitoring of healthcare capacity and essential supplies through the National Healthcare Safety Network (NHSN) is critical to ensure adequacy of care.Because no single system can capture all parameters of the pandemic, CDC has implemented multiple, complementary surveillance systems (Appendix A). Key systems are case-based reporting through the National Notifiable Diseases Surveillance System (NNDSS), laboratory-based surveillance, syndromic-surveillance data reported through the National Syndromic Surveillance Program (NSSP), and data on healthcare system capacity reported through the NHSN (Appendix B). Additional systems, such as COVID-Net, provide rich, publicly available information for meeting secondary objectives. CDC continues to explore emerging and experimental surveillance platforms with a critical eye toward proven utility.Control of the epidemic requires action at the individual, community, and population levels. CDC has provided state, tribal, local, and territorial health departments with extensive detailed guidance on contact tracing, infection control, and a wide range of other prevention and control topics. Recent models suggest that asymptomatic and pre-symptomatic transmission and delays in case recognition can greatly reduce the effectiveness of contact tracing. To enhance the speed and thus effectiveness of contact tracing, CDC is exploring technologic methods for instantaneous voluntary notification of contacts of confirmed cases.At the community level, recent events have shown the devastating effects that outbreaks can have among vulnerable populations, especially those in congregate settings such as nursing homes, prisons, and homeless shelters. Similarly, outbreaks in food production plants and other critical industries are crippling communities financially and threatening national food security. Rapid identification and response to these events is a CDC priority that can mitigate the immediate impact and provide critical insights needed to prevent future outbreaks in similar settings. CDC has developed extensive tools to assist states, counties, facilities, and industries in responding to and preventing these events (Appendix C).Widespread community mitigation combined with ongoing containment activities represents both an effective intervention for limiting the spread of COVID-19 and a serious threat to the economic well-being of the country and the world.Publication date from document properties.CDC-Activities-Initiatives-for-COVID-19-Response.pdfCDC Activities and Initiatives Supporting the COVID-19 Response and the President\u2019s Plan for Opening America Up Again -- Appendix A: Surveillance for COVID-19 -- Appendix B: Healthcare System Surveillance -- Appendix C: Guidance on Infection Control and Contact Tracing -- Appendix D: Guidance on Test Usage (Asymptomatic Populations and Serology).20207703Supersede

Marshfield Clinic: Health Information Technology Paves the Way for Population Health Management

Highlights Fund-defined attributes of an ideal care delivery system and best practices, including an internal electronic health record, primary care teams, physician quality metrics and mentors, and standardized care processes for chronic care management

A Bold promise to the nation : CDC strategic framework & priorities : 2020 annual report

We are excited to share with you the accomplishments and milestones reached through the Strategic Framework and Priorities in 2020.CDC\u2019s Strategic Framework centers our work around the agency\u2019s core mission to save American lives by Securing Global Health and America\u2019s Preparedness, Eliminating Diseases, and Ending Epidemics. Our work in these areas and across public health is dependent upon CDC\u2019s core capabilities: world-class data and analytics, state-of-the-art laboratory capacity, a skilled public health workforce, the ability to respond quickly to outbreaks wherever they occur, and a strong foundation for global health capacity and domestic preparedness. With this framework as our guide, CDC put science into action across multiple initiatives in a truly unprecedented year.314229-UPublication date from document properties.cdc-2020-annual-report.pdfOverview -- COVID-19 -- Key Stategic Activities an Accomplishements -- Workforce -- Looking Forward.2021904

Providing Resources for the Advancement of Rural Broadband in Native Communities

The Pueblo people have existed in the southwestern United States for millennia. Today, the Santa Fe Indian School provides secondary education to children from the 19 remaining Pueblos in New Mexico. Our group worked with Kimball Sekaquaptewa, the school’s IT coordinator, to support her broadband upgrade efforts by assessing rural internet availability and exploring ways of encouraging its effective use among pueblo populations. We collected data about the current state of pueblo internet use and attitudes through interviews, surveys, and speed tests. These findings provided a baseline dataset for further tests to build upon, and informed infographics that we created to share our findings among various native constituencies

Introduction: a Frame for the Discussion of Learning Cultures

In this chapter the authors identify a gap in research on culture in online learning and offer a frame for the discussion of the best-known frameworks available for cultural analysis outside the online world. They go on to describe the developments driving the need to problematize 'learning cultures' for the online world, such as the growth of multiculturality, the expansion of transnational e-learning and new media communication practices

The India MPA Workshop Proceedings. Social Dimensions of Marine Protected Areas Implementation in India: do Fishing Communities Benefit? 21-22 January 2009, IMAGE Auditorium, Chennai, India

In the current context of natural resource management, marine protected areas (MPAs) are being widely propagated as an important tool for the conservation of marine and fisheries resources. The International Collective in Support of Fishworkers (ICSF) recently undertook a series of studies on MPAs in India to highlight the various legal, institutional, policy and livelihoods issues that confront fishing and coastal communities. In order to discuss the findings of these case studies and to suggest proposals for livelihood-sensitive conservation and management of coastal and fisheries resources through participatory processes, ICSF organized a two-day workshop on ‘Social Dimensions of Marine Protected Area Implementation in India: Do Fishing Communities Benefit?’ at Chennai on 21-22 January 2009. This publication—the India MPA Workshop Proceedings—contains the prospectus of the workshop, a report of the proceedings and the consensus statement that was reached by organizations and individuals who particapated in the workshop. This publication will be useful for fishworkers, non-governmental organizations, policymakers, trade unions, researchers and others interested in natural resource management and coastal and fishing communities

Lifeline: Tech innovations for maternal and child health - Part 2

At 16% and 27%, India contributes the highest global share of maternal and new-born deaths. Most of these are preventable through simple, proven and low-cost solutions. With close to a billion mobile phones and over a million broadband connections, Information and Communication Technologies (ICTs) can address the key informational and process challenges to RMNCH+A in India.Dasra's report, Life Line, lays out the key challenges and solutions, alongside the work of scalable and impactful social organizations for funders' consideration

Immunisation coverage and its associations in rural Tanzanian infants

Introduction: In Tanzania, vaccination rates (VRs) range from 80% to 90% for standard vaccines, but little information is available about rural populations and nomadic pastoralists. This study investigates levels and trends of the immunisation status of infants at eight mobile reproductive-and-child-health (RCH) clinics in a rural area in northern Tanzania (with a large multi-tribal population that has a significant population of nomadic pastoralists) for the years 1998, 1999, 2006 and 2007. In addition, the influence of tribal affiliation and health system-related factors on the immunisation status in this population is analysed. Methods: Vaccination data of 3868 infants for the standard bacillus Calmette–Guérin (BCG), poliomyelitis, diphtheria, pertussis, tetanus and measles vaccines were obtained from the RCH clinic records retrospectively, and coverage for both single vaccines and full vaccination by the end of first year of life were calculated. These results were correlated with data on predominant tribal affiliation at the clinic site, skilled attendance at birth, service provision and vaccine availability as independent variables.Results: In 1998, the full vaccination rate (FVR) across all RCH clinics was 72%, significantly higher than in the other years (1999: 58%; 2006: 58%; 2007: 57%) (p 80% was only achieved at one clinic during 3 years. No clinic showed a consistent increase of VRs over time. In univariate analysis, predominant tribal affiliation (Datoga tribe) was associated with a low FVR (odds ratio (OR) 4.6 (95% confidence interval (CI) 3.8–5.5)), as were low rates of skilled attendance at birth (OR 3.6 (CI 2.9–4.4)). Other health system-related factors associated with low FVRs included interruption of scheduled monthly immunisation clinics (OR 9.8 (CI 2.1–45.5)) and lack of vaccines (OR 1.2–2.9, depending on vaccine). In multivariate analysis, predominant Datoga tribal affiliation and lack of vaccines retained their association with the risk of low rates of vaccination. Conclusions: Vaccination rates in this difficult-to-reach population are markedly lower than the national average for almost all years and clinics. Affiliation to the nomadic Datoga tribe and lack of vaccines determine VRs in this rural population. Improvements in immunisation service delivery, vaccine availability, stronger involvement of the nomadic communities and special outreach services for this population are required to improve VRs in these remote areas of Tanzania