Tag Archives: data

Evidence-Based, Data-Driven

Calcutta Kids has always been focused on a data-driven approach to improve the status of maternal and child health and nutrition in Fakir Bagan. We have been collecting, monitoring and evaluating data from the field regularly to inform our programmatic interventions. We teamed up with a creative and passionate group of individuals from the Social Impact Program at ‘Thoughtworks’, a software company in the US with offices across India. They worked with us to enhance our old database, review the existing monitoring systems and helped create an updated and user-friendly tool.
The new ‘MYCHI database‘ is a tool to enhance the provision of health and other services to groups of pregnant women, mothers and children. The database collects and stores health and other information about women and children, displays the information on individual dashboards and uses visual representations of data and series of predefined reports to guide program management on the ground. The database is open source software, meaning its code is free and with the help of a developer, it can be tailored to the needs of a wide range of organizations.

The MYCHI database was developed around three overarching objectives

    1. To empower implementers with the tools to practice “developmental evaluation” and make evidence-based adaptations to a program, and maximize the impact on the beneficiaries.
    2. To monitor and guide day-to-day organizational operations and focus on beneficiaries in need of special attention.
    3. To identify beneficiaries who may fall through the cracks as they may not independently show up to receive the preventative care.

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MYCHI’s foundation is built around information most public health organizations collect about their beneficiaries such as: i. monthly weight and height of children and pregnant beneficiaries, ii. attendance at immunization sessions and iii. incidences of illness to name a few. Once uploaded, MYCHI displays this information on graphs and in reports and uses it to guide day-to-day program management.

Building on this foundation, MYCHI can be tailored to collect a vast amount of additional information about beneficiaries relevant to an organization’s focus and interests. Using beneficiary survey data collected in adaptable online forms, an organization can capture data points as varied as socioeconomic status, medical history and access to government services. This information can be analyzed to identify correlations between demographics and health indicators, red flags in beneficiary health and health seeking behavior, even the success or failure of a programmatic intervention.

Key Features

Dashboard

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A personalized dashboard is generated for every beneficiary immediately following his or her registration. The dashboard displays basic information, familial relations and links to any previously submitted forms. A child’s dashboard displays weight and height records from all GMP sessions on growth charts for growth tracking and captures a child’s personal immunization schedule in a color-coded table that indicates immunization status, (i.e. given, due, critical, overdue.)slide3

 

 

 

 

 

 

 

 

 

Growth Monitoring and Promotion (GMP) and Immunizations

MYCHI makes tracking and encouraging attendance for GMP and Immunization sessions easy using reports that display the names of all beneficiaries due for an upcoming session. Over the course of a three-day GMP session, a report is filled with the height and weight or absent reason of every beneficiary. An Immunization report will be similarly filled during an immunization session as beneficiaries receive their inoculations. When the reports are uploaded, GMP and Immunization data is stored, displayed on beneficiary dashboards and accessible for analysis.

Jasper Reports

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Data is pulled from the backend using reports written in SQL and generated in Jasper. These predefined reports fall into three broad categories, program management reports, status reports and reports for analysis. The first category includes reports that track our progress completing regular tasks like ANC visits for all pregnant women over the course of a month. An ANC status report will identify those beneficiaries who have not been visited so we can complete their visit in the time allotted. These reports help us stay accountable to our beneficiaries in providing the services integral to our program.

The second two categories, status reports and reports for analysis, display information pulled from forms and uploaded reports that a program manager can use to develop new programs and organize work flow.

The MYCHI Database has streamlined the work and improved the monitoring and evaluation systems at Calcutta Kids. As a result, our approach is more targeted and we are able to focus our attention to those who need it the most.

– Post by Lilian Olson

C-Section Blog Series (1 of 4)

For the month of July, Calcutta Kids’ weekly blog will be on the topic of C-section deliveries, and the challenges of working in maternal and child health during a time when C-sections are becoming the norm.

According to a December 2011 article  in the Telegraph, West Bengal “has more Caesarean section deliveries in private hospitals than anywhere else in the country”, and Kolkata has the highest rate at 33.5%. C-sections are convenient for doctors and lucrative for facilities, so doctors are beginning to schedule deliveries regardless of a medical need. Some of the best private hospitals in Kolkata have even removed labor rooms altogether, and only offer the C-section option.

C-section deliveries can lead to serious complications such as hemorrhage, lingering abdominal pain, hernia, blood clots, and long-term effects including a required hysterectomy and even death. C-sections can also impact the child, and can lead to increased incidence of asthma and allergies, as well as possible neurological disorders. In addition, C-sections are expensive and recovery time is often greater than for a vaginal birth. As a public health organization, Calcutta Kids encourages best practices for maternal and child health. This includes safe prenatal care; a vaginal, facility-based delivery (wherever possible); access to comprehensive emergency obstetric and newborn care; exclusive breastfeeding for the first six months after birth, and critical health messages given to the new mother and family.

Through this series, readers can learn more about C-section rates in India and West Bengal, decisions made at the facility level, and our difficulty in having an impact in the delivery room. We will also share what Calcutta Kids is trying to do to empower women through birth preparedness, and welcome your comments and suggestions on ways we can address these challenges. -Margy Elliott

Immunizations – More Than Just a Shot

The immunization program has been a service of Calcutta Kids for many years, but during the last year, we have worked very hard to make it as effective and efficient as our GMP program. There are two primary ways that we have accomplished this; the first is a short multimedia education and counseling session and the second is a system in our database that tracks the immunizations for each child and correctly identifies those who are eligible for that week’s clinic.

Rather than simply telling mothers and caretakers that these immunizations are necessary, we are working to inform our beneficiaries about why these immunizations are important. The short education and counseling session is designed to convey information on both the disease (or diseases) that the immunization is preventing, and on possible side effects. We have already seen mothers taking a larger interest in the immunization program and asking the CHWs about the next session. And for those not taking the initiative, we have an accurate list of all children who should come to the clinic and take the time to remind each household on that list. Take a look at the immunization counseling materials here.

The immunization section of the database has been greatly improved in the past year, and now takes into account the immunizations that have been received and the dates of each immunization received. This is important because many children have missed doses and are therefore off the ideal schedule. For example, a child may have received the first dose of DPT, OPV and Hep-B, but then did not receive the second dose after four weeks, but instead returned after eight weeks. According to the age, the child should be receiving the third dose but in fact, he or she should be receiving the second dose. The system also makes sure that enough time has passed between doses. These two improvements are helping us toward our goal of full immunization for each child that participates in our program. -Dora Levinson

Data-Driven Decisions

Calcutta Kids is committed to the collection and use of data in order to provide beneficiaries with the most effective and efficient services and care possible. We now have electronic data on women and children dating from November 2009, and have been working hard to not simply collect data, but be an organization that uses our data effectively.

We have been particularly pleased with our use of data relating to immunizations. In earlier years, the name of each child and the immunization he or she received was simply recorded in a notebook. One of our volunteers spent three weeks sorting out the immunization history and requirements for each child. We now have a protocol followed during each immunization session including protocol for recording information directly into the database. Each week, we are able to print out an accurate list of children that are due for immunizations. This list takes into account the age of each child and the previous immunization history, to assure that 1) no child is getting an immunization before he or she is ready; 2) no child is getting a second or third dose too close to the previous dose; and 3) no child is having an immunization after he or she has passed the age when the immunization is viable. No one falls through the cracks!

A second example is the database used at the Calcutta Kids Diarrhea Treatment Center, which not only helps with tracking individual patient data and center level indicators and statistics, but actually helps with the clinical patient care. The CKDTC database automatically calculates the level of dehydration of each patient based on WHO guidelines, and the weight-for-age z-score (a measure of underweight). The database alerts staff when a patient is in need of a check-up or when other action is needed.

While we currently have local databases, we hope in the future, with help from the Jolkona Foundation, to move to a web-based system that will allow for multi-user input and extraction from separate locations.