3. Initial Brainstorming
Initially, we sat down around a table, with white
board, post-its, markers and sketch pens in
hand.
We gave ourselves 5 minutes, in which each
member had to think individually and bring as
many ideas as possible.
After 5 minutes, all the ideas were discussed.
Some were rejected and some were shortlisted.
This process was repeated several times until
the team had a pool of ideas, decent in quantity
and quality.
4. Initial Ideas
After going through the series of brainstorming
sessions over 3-4 days, we finally came up with
the following ideas:
- To enhance the learning experience of school
going kids (in the school environment) of 3-8
years
- To motivate kids to move out of the digital environment and interact with the physical surroundings (7-12 years)
- To aid and simplify the learning and communication (so that it becomes easy for them to express their ideas) for deaf and dumb
5. Narrowing down
After analyzing all the topics that were shortlisted, team realized that it wants to do something for the society they live in (as a moral responsibility). We wanted to do something for the people of Rural Assam.
And we even realized that there are some keypoints which should be taken into consideration while
choosing the topic for the semester project. They were:
- Easily available users
- Problem oriented / Need based
- Field trips should be possible
After going through all these points, we narrowed down to the topic on which we wanted to work on.
6. project brief
The team decided to work on the following topic:
“ To make Adolescent girls (11-18yrs) aware of health and hygiene (physical,
psychological and hormonal) related issues during puberty. ”
8. brief
To understand the situation of adolescent girls and their problems, we went on to study a series of
research papers, newspaper articles, medical blogs (by medical companies and hospitals) and government schemes like Kishori Shakti Yojana.
After getting some idea, we studied the problems of adolescents of North-East, especially in Assam.
However, there was not much documentation on this problem for this part of the country. Hence, to get
the exact view, we decided to go for the field trips to the villages of Assam located near to IIT Guwahati.
We met with one of the maids of Subansiri named Moon, and talked to her about the problem. By talking
to her, we got to know about the health system existing into the villages. Going deep into the conversation, we came to know about the Primary Health Centre established in the North Guwahati Block under
National Rural Health Mission (NRHM). We already came across NRHM under our literature study, but we
decided to validate the facts that we came across during the Literature Study.
9. Fig 1. Times of India report on the problem pertaining to the adolescents in the society (urban)
10. Fig 2. Report on the ‘Needs and Problems of Adolescent Girls in India’
11. Fig 3. Research Paper - A study on the ‘Prevalance of Anaemia’ in 16 districts of India
12. Fig 4. Research on how the women and adolescent girls could be empowered in developing countries like India
13. Fig 5. A study on the nutritional aspect of the adolescents, specific to the culture of Assam in the Dibrugarh District
14. Fig 6. Research paper on the behaviour of adolescent girls of rural areas to know about their health problems
15. Fig 6. Research paper on the behaviour of adolescent girls of rural areas to know about their health problems
22. brief
After the literature study, we realized that there was not much documentation on the problems of Adolescent Girls in this part of the country (North-East). Hence, to get the exact view, we decided to go for
the field trips to the villages of Assam located near to IIT Guwahati.
We met with one of the maids of Subansiri named Moon, and talked to her about the problem. By talking
to her, we got to know about the health system existing into the villages. Going deep into the conversation, we came to know about the Primary Health Centre established in the North Guwahati Block under
National Rural Health Mission (NRHM). We already came across NRHM under our literature study, but we
decided to validate the facts that we came across through field trips.
26. INFERENCE
After the first field trip, we got to know about
the structure setup under National Rural Health
Mission. We were told that the system is self-sufficient and efficient. However, in order to cross
check the facts presented to us by PHC, we
planned our second field trip to a subcentre
located in Mauryapatti.
Primary Health
Centre
Sub-centres
(Auxiliary Nurse Midwives)
ASHA
Local Community
(Pregnant women, Adolescent Girls, Child etc.)
29. INFERENCE
This field trip made us understand the importance of ASHA (Accredited Social Health Activist). She plays a major role in the hierarchy and
most of the work is done by her.
She acts as a link betwen the local community
and the health providers.
Thus, our third field trip was aimed to meet an
ASHA worker and understand the system
through her point of view.
32. INFERENCE
ASHA (Accredited Social Health Activist) is the
most important part of the system. She is a lady
who acts as a link between the local community
and the health service providers (PHCs, Auxiliary
Nurse midwives, hospitals etc.)
Her roles and responsibilities include: to take
care of pregnant women, adolescent girls, the
village community, to make the village health
plan, to create awareness of HIV/AIDS, communicable diseases etc. She is a single person in the
system who has to perform all these tasks and at
the same time prepare all the paperwork for
documentation.
More appalling is, that ASHA isn’t trained well, as
the training programs run only for 20-25 days.
ASHA is a part of the community, and everyone
in the locality has deep faith in her.
People often listen to ASHA over the doctors
and what other people say.
If ASHA is trained well, then she could easily and
effectively transmit the correct information to
our target audience of pregnant women.
34. problem redefined
In the hierarchy set up under the NRHM, ASHA plays a very
significant role. People tend to agree and follow to what ASHA
say. She has various roles and responsibilities. She is supposed
to know about :
• Basic health and Hygiene
• Basic Sanitation
• Nutrition and importance of healthy diet
• Pregnant Women: Counseling, Birth preparedness,
Tests like Prenatal Screening test, antenatal and
post-natal care etc.
• Adolescent Girls: Counseling, Awareness about
puberty and physical changes in her body etc.
• Communicable diseases and how to prevent them
• Developing Village Health Plan
• Constructing of househeld toilets
• Care of new born and management of a range of
common ailments
• Inform Births, deaths and unusual health problem
or disease out break
These are a few of many things she should know. However, in
reality she hardly knows anything. To get to the root of this
problem, the team conducted several field trips in the villages
of Assam and surveyed many ASHAs.
The ASHAs were found to be enthusiastc about their work, but
they were never trained properly. They were not given systematic information through trained personnel.
They generally gain their knowledge through experience, and
then transfer it to their successors. Their training program runs
for about 2-3 weeks, and in some states it stretches to 6
months. The way the ASHA is trained is very unsystematic and
not uniform. However, through various interviews of ASHA
that were conducted by the team, it was evident that if ASHAs
are given proper training, then most of them would be able to
transfer the knowledge to the adolescent girls and other
people in the community, as they are high on enthusiasm.
A solution directly affecting the adolescent girls was not possible as girls were too shy to adapt to new things to teach them
about their body. However they shared a good equation with
ASHA workers. So, if we train ASHA workers, then they in turn
could benefit the adolescent girls and other people of their
community by transferring the knowledge imparted to them
during Training.
Hence, we decided to work on the training of ASHA members,
so that all sections of the society could be helped.
35. PERSONA
Sonamati Sarkar is an ASHA member from Kating Pahad area in Assam. Her home is far
off from the village so she has to walk a lot everyday in order to attend to the pregnant
ladies in the village. She imparts all the knowledge she has to the pregnant women and
adoloscent girls of the community.
ROLE AT HOME
Take care of kids and family.
Keep a note of hygiene and sanitation
of the house.
Educate the family to grow better.
DEMOGRAPHICS
Sonamati Sarkar
6th Standard
34 years
Married
INCOME
No fixed salary.
Awarded as Rs.300 after every trimester,
if she takes care of the lady properly.
If every pregnant women has an
institutional delivery in her village, she is
awarded as Rs.8000 at the end of the year.
RESPONSIBILITIES AS ASHA
Provide quality care to the pregnant lady during antenatal, intranatal and postpartum
period.
Counsel women on birth preparedness, importance of safe delivery, breast-feeding
and complementary feeding, immunization etc.
Mobilise the community and facilitate them in accessing health and health related
services available at the Anganwadi/sub-centre/primary health centers.
Provide health services for children by anganwadi workers and Primary Health Centre
(PHC) staff, include regular health check-ups, recording of weight, immunization,
management of malnutrition, treatment of diarrhoea, de-worming and distribution of
simple medicines etc.
Help AWW to complete and update village health register.
36. existing solution
Under the National Rural Health Mission (NRHM), ASHAs in
different states are trained differently. Training is done
through programs, in the form of classroom education. They
include workshops, training courses, scientific meetings,
seminars, symposia, and so on.
In some states, two to three level hierarchy has been setup to
train ASHAs. For eg. In Uttar Pradesh, ASHA is first trained by
block level trainers. These trainers are further trained by
district level trainers who get their information from the state
level trainers.
(http://www.upnrhm.gov.in/achievements-asha.php)
This kind of system wastes a lot of time, and the human
resource as well.
In some other states, the state government has tied up with
certain institutions / organizations, and has given them the
responsibility to train the ASHAs. For eg, the Maharashtra
Government has tied up with an organization named ‘Sathi’
which trains the ASHAs by calling them together at one place,
similar to classroom learning. National Institute of Health and
Family welfare (NIHFW) also collaborates with some state
governments to help them in training of ASHA.
In states like Tripura, there is no particular organization which
gives proper and systematic training to ASHAs. They have to
depend on Medical colleges, State and District hospitals to
train their ASHAs.
37. existing solution
The material given to ASHAs while training is in the form of
handbooks, print material, documents, pamphlets, brochures
etc. Eg. For Anemia, she is provided one handbook (http://nr h m . g o v. i n / i m a g e s / p d f / p r o g r a m m e s / w i f s / g u i d e lines/technical_handbook_on_anaemia.pdf ) , whereas for
tests of pregnant women, she is provided another material.
And this scenario is also not fixed. It differs in different states.
This implies that ASHA is provided with piles of handbooks
and documents, which she doesn’t even like to refer and
hence, she doesn’t get the full knowledge about her responsibilities.
Thus, the training program could be enhanced or replaced so
that the information to ASHA flows in a systematic, uniform
and logical manner. This would decrease her cognitive load,
and will help her in understanding her actual role in the soci
ety.
38. proposed solution
After analyzing the whole system, the team came to the conclusion to work on the training of ASHAs.
The team proposes a simple-to-use, low cost device that
would be used by ASHA workers for their training. With the
help of interactive videos / animations / graphics, ASHA
would be trained by going through all the possible scenarios
in virtual reality. The device is made in such a way, that it
easily fits into the hand of any normal women, and is easy to
carry. ASHA will carry the device with her, and through these
interactive tutorials, she would eventually learn what her
roles and responsibilities demand.
A ‘virtual ASHA’ would be present on-screen of the device,
and she would guide the ASHA (to-be trained) by making her
visit in all the possible scenarios / situations. This would be
interactive, and the flow of tutorial will depends on the way
the ASHA responds to the questions asked by the virtual
ASHA.
The training device would become obsolete once it trains the
ASHA well. To get away with this, few features have been
added so that the device would assist ASHA in explaining
things to people like pregnant women even when her training is complete. This will increase the longevity of device in
terms of usage.
Virtual ASHA guiding through the tutorial
Details of the product
The device has following features:
•
•
•
•
Foldable like laptops
8-inch big screen
Big buttons – Each one for a specific function
A carry case similar to a purse, so that ASHA could
carry the device with ease, and feel personalized
with it.
39. proposed solution
For the easy understanding, systematic and logical flow of
the knowledge – all the information to ASHA will be accessed
through buttons. The keyboard of the device is segregated
into three parts – ‘During Training’ and ‘Post training’, and
‘General keys’.
There are five keys each in ‘During Training’ and ‘Post Training’
parts, each for the following modules:
•
•
•
•
•
Pregnant women
Adolescent Girls
Children
Family Planning and Sex Education
Basic health, hygiene and sanitation
Each module contains the information and the tutorials related to them. So, in this way the whole information is categorized and logically provided. All the tutorials related to pregnant women will be accessible, as soon as the ASHA presses
that button.
When the device will be handed to ASHA, the ‘Post Training
keys’ would be covered with a lid and screwed. ASHA will not
have access to them. It is done to reduce the cognitive load.
Low - fidelity mockup of the device
40. PROPOSED SOLUTION
‘General Keys’ section will contain the basic keys like:
•
•
•
•
•
Enter button
Navigation Keys – for left and right
Health Remedy Button: This button will be a quick
access button. In case of some emergencies, ASHA
could press this button and get access to list of
home remedies.
Role of ASHA button: This button would tell ASHA
about her roles which are generic and cannot be
classified in any of the above modules. For eg.
ASHA needs to take a sick person to the hospital,
and get him consulted by doctor if the case is
severe. Tutorials related like this would be present
under this button.
Reminder: This is an add-on feature. ASHA will be
able to set reminders, so that she could remind
herself when to take the pregnant women for the
screening tests.
Once the ASHA is fully trained, the lid from the ‘Post Training
Keys’ would be unscrewed, and now the whole keyboard
would be available to ASHA.
Pregnant women button of ‘Post Training keys’ would contain
the info-graphics / videos that would aid ASHA in explaining
the situation of the pregnant women to the women itself.
Similar role is assigned for the other keys.
Similar shape and colors are used to help in categorizing the
similar information. The ‘During Training keys’ are square in
shape. The ‘Post Training keys’ are circular in shape. So, there is
a clear-cut demarcation of information through basic shapes.
Moreover, each module is assigned one color code. For eg.
Pregnant women button in both ‘During training’ and ‘Post
training’ are of same color.
Tutorial / Content in the device
On pressing the Pregnant Women button of During Training
keys, the ASHA would see a virtual world on her screen with a
‘virtual ASHA’. That ‘virtual ASHA’ would interact with the real
ASHA (to be trained) through dialogues and narratives. She
would take the real ASHA through all the possible scenarios /
situations in the virtual world, and will keep interacting and
guiding her simultaneously. The virtual ASHA would ask
questions, which she needs to answer. Depending on her
answer, the flow of the information will be decided.
41. information architecture
Pregnant
women
Provide quality care to the
pregnant lady during antenatal,
intranatal and postpartum period.
Counsel woman on birth
preparedness
Importance of safe delivery
Breastfeeding and complementary
feeding
Adolescent
girls
Regarding nutritions and diet.
About contraceptives and
sanitation.
About the use of Sanitary
napkins.
Information regarding
abdomen pain in girls.
Immunization and contraception
methods
About changes in physical
and psychological state.
Prevention of common infections
including Reproductive Tract
Infection/ Sexually Transmitted
Infection (RTIs/STIs)
Identify danger signs during pregnancy,
delivery and postpartum period along
with the danger signs in the newborn
and provide supportive care prior to
referral.
Provide them with iodine
tablets.
Imparting information about
the menstruation cycle and
bodily changes.
Follow routine infection prevention
practices during pregnancy and child
birth.
Role of
ASHA
ASHA will be the first port
of call for any health related
demands of deprived sections
of the population, especially
women and children, who
find it difficult to access health
services and she will create
health awareness.
Counsel women on birth
preparedness, importance of
safe delivery, breast-feeding
and complementary feeding,
immunization etc.
Mobilise the community and
facilitate them in accessing
health and health related services
available at the Anganwadi/subcentre/primary health centers.
Will act as a depot older for
essential provisions being made
available to all habitations like
Oral Rehydration Therapy (ORS),
Iron Folic Acid Tablet(IFA) etc.
Help AWW to complete and update
village health register.
To increase institutional delivery
by continuing with the JSY( Janani
Suraksha Yojna) Scheme.
Child Care
(0-5 years)
To improve the nutritional
and health status of children
in the age-group 0-5 years.
To reduce the incidence
of mortality, morbidity,
malnutrition etc.
Immunization, health
check-up, referral services
of the kids.
Provide health services for
children by anganwadi workers
and Primary Health Centre (PHC)
staff, include regular health
check-ups, recording of weight,
immunization, management of
malnutrition, treatment of
diarrhoea, de-worming and
distribution of simple medicines
etc.
Family
planing
Birth control using
contaceptives,
permanent contraceptive methods
such as surgery of
falopian tube.
Sterilization
Female contraceptions
Implants, IUD and
Mucus Methods
Financial Aspect
42. scenario
For a better understanding, a scenario is presented below. This shows how the virtual ASHA guides the real ASHA (who is
to be trained) through the tutorial
ASHA acts as one of the
best friends of the pregnant women and takes
care of them, by visiting
their house periodically.
One of the pregnant
women experienced a
labour pain, and called
ASHA. She rushed to her
and consoled her.
She called the ambulance from the nearby
hospital.
Ambulance
came to the place within
5 minutes.
ASHA took the pregnant
woman to the hospital
for the safe delivery of
the child. Both mother
and child are now safe
and healthy.
This is how the ASHA would be taught about her roles and responsibilities, through the virtual reality.
43. feasibility
The proposed device would be a digital system. This is considering the fact that production methods in the digital realm
are becoming more and more cost effective with time.
Recent mobile phone models like Nokia 101 and Nokia 100
have used this display technology and effectively reduced
cost (of the complete device) to a range of Rs. 1000 - Rs. 2000.
Small size, low fidelity videos of formats like 3GP, AVI, MP4,
WMV, MPEG-4 could be played in this system. The processor
would also be capable enough to play small flash animations
as well.
The battery of the proposed device can be a Lithium Polymer
battery, which is rechargable, and roughly estimated to give a
playback time of approximately 3 hours. A close example is
the Archos 405 video player, which has a screen size of 3.9” x
3.1”, with rest all features almost same, and gives a video playback time of 5 hours.
Since the videos / animations are going to be put in the storage card by a single central system, this format could be standardized. In effect, usage of a single video format will reduce
the processor load.
The proposed device will use data stored from a microSD
card. Data storage can be held in a microSD card of 2GB or
more. A bulk production will ensure that the memory card
cost is around Rs. 100 - Rs. 150 per piece for a 2GB memory
card.
The proposed device uses an LCD Transmissive screen, which
is generally used in simple mobile phones. The display colors
will be HighColor (16-bit/64000). As explained in the proposed solution, the video content played on this device will
be through simple graphics and 2D animations, so that a
High Fidelity video player is not a prerequisite.
The processor of this device has to be such that it can support
video playback of low fidelity videos, play/pause/stop functions for videos, forward/backward function for videos,
volume increase/decrease and setting up of reminder. Thus,
requirements are quite low, and processors with these capabilities exist in the market at cheap price.
The casing of the proposed device is a Silicone fibre casing, in
order to manifest the attributes of the device being light and
portable, heat resistant, and adaptable to rough usage.
As a part of the system of NRHM, this device can be manufactured in bulk, and thus can be made cost-effective.
44. conclusion
The project aimed to create awareness and improve the
health of the pregnant women and their child after delivery.
After series of user researches, it was analyzed that pregnant
women are reluctant to new changes in their society (cultural
aspect). However, they listen to ASHA of their locality, as they
have trust in her.
ASHA, although being an enthusiastic worker is not able to
provide correct information and is not able to take proper
care of the mother and child as she is herself not well-versed
with the details. The reason behind this was improper training program of ASHA.
Thus, the team proposes an alternative of training program –
a device for ASHA which will make use of virtual reality and
train the ASHA by making her visit every possible scenario in
the virtual world.
The device can be used for different purposes in the future to
assist ASHA even more. It could help her in documenting all
the things, which is a tedious task and takes months to complete. This device could also be used a source of communication between the ASHA and other higher authorities, by
making some minor modifications.
