Photo: Star Archive
Acombination of rapid proliferation of mobile technologies coupled
with improved connectivity has opened up innovative possibilities for
ICTs in last-mile service delivery like never before. While the impact
is being seen in many areas of service delivery, radical changes are
taking place particularly in community-based healthcare and agriculture
extension services. The following are some areas where there is
significant scope for radical shifts as a result of the innovative use
of ICTs.
Decentralisation of expert services
Experts are hard to find, particularly in the health and agriculture
sectors. We cannot increase their numbers in the short term either.
Another problem is that a large percentage of these experts tend to be
based in cities, thereby making service delivery in rural and
disadvantaged areas even more challenging. So we have to find a way to
take the services of experts to these areas using whatever relevant
resources we have at the community level and connect these areas with
experts using various ICT tools.
In health, there are initiatives underway that connect certified
rural medical practitioners (RMP), such as “pharmacists” (who sell
medicines in rural areas, more commonly albeit, derogatorily known as
quack doctors) or community-based health workers to doctors through
technological tools. The RMP uses applications on tablets or smartphones
to capture patient information systematically following medical
algorithms and when submitted, the medical record gets transferred over
to a doctor with a desktop who looks at the data, opens a communication
channel to speak to the patient directly, instructs the RMP for further
investigation if required, and writes down a prescription, which gets
instantaneously transferred over to the mobile device of the RMP. This
e-prescription can also be printed if the RMP has access to a printer.
In agriculture, initiatives are being taken to connect agriculture
extension workers such as government Sub-Assistant Agriculture Officers
(SAAOs), agriculture input sellers, info-mediaries at rural tele-centers
and so on, to capture problems that farmers are facing in the fields
and send these to an agriculture expert for review and recommendations.
The recommendations can be transferred to the farmer via phone calls,
text messages or voice messages.
The above mentioned are cases where certain functions of an expert
are being “decentralised” to non-experts with some degree of relevant
knowledge, under the direct supervision of experts. These new modes of
service delivery will obviously not be able to address all underlying
issues – but there are certainly some cases that can be effectively,
particularly cost-effectively, handled by such remote consultation,
thereby reducing chances of exploitation and mistreatment of
disadvantaged people.
Optimised workflow of field forces
In both health and agriculture, there are literally thousands of
field workers who are the last-mile solution providers to the
beneficiary. In health, community workers undertake a variety of
activities which need optimisation, such as determining which households
to visit and when, reporting on activities at regular intervals,
disseminating messages, etc. Each community health worker is generally
responsible for covering nearly 2,000 households, which makes workflow
optimisation extremely important to ensure prioritised interventions
based on need.
For instance, a project called mTika has been piloting the use of
mobile phones in the optimisation of vaccination delivery services. This
project enables digital recording of birth information of every newborn
in the pilot area, and tracks whether the child comes to vaccination
camps on time. Reminder messages are sent prior to a health camp, and if
they do not show up targeted household-based investigation or advocacy
can be undertaken.
In the area of agriculture, agriculture extension workers need to
disseminate messages to hundreds of farmers regarding the time and
location of training sessions that they regularly hold. In another
ICT-based project, the farmers in the pilot location are pre-registered
into an information system. As soon as a training session location and
time are planned, an automated mass text message goes out to the farmers
in that particular locality, thereby saving significant costs and time
spent on letting them know about the event via physical visits.
Capacity building of field forces
In both health and agriculture, training of field forces is an
extremely expensive affair. Now, various mobile-device based
applications are being developed that enable community health workers
and agriculture extension workers to update their knowledge as and when
needed.
Health-related training materials are being digitised and put into
the tablets and smartphones of community health workers for self-paced
learning. Gaming applications are also being developed for learning
through entertainment. Short videos that can be disseminated through
mobile phones and seen at leisure or shown to beneficiaries are also
being developed. This mode of communication enables a low-cost mechanism
for training and capacity building.
Decision making
Another critical outcome of information being collected at the field
through mobile devices is that the data gets automatically digitised at
the point of collection, which can be sent throughout the entire
management chain. This means different layers of management can use that
data to make decisions and send appropriate instructions down the
chain.
Health administrators can use dashboards for targeting interventions
such as medicine supplies or health camps based on real-time data sent
from the field. Agriculture administrators can use it to plan for
possible shortages or surpluses in certain crops, forecast pest and
disease problems in a particular locality and take measures accordingly.
Conclusion
Opportunities arising out of the proliferation and advancement of
mobile technologies are endless. We will soon be entering a world where
all phones will be smartphones, access to the internet will be
ubiquitous and cheap, field workers will be equipped with technologies
and diagnostics tools, and beneficiaries will be able to access
information on demand – all this is bound to fundamentally change the
nature of service delivery at the doorstep for the better in ways that
we cannot even imagine today. What we are doing now is just a drop in
the bucket in preparation for what is to come.
The writer is CEO and Founder of mPower, a technology-based social enterprise.