mSehat: A Disruptive Innovation Transforming Rural Healthcare

Jan 11, 2017 posted by Phani Madhav under Digital Transformation, Technology

mSehat features in WHO reportThe term “disruptive innovation” floods much of our contemporary business literature, though its usage is often far removed from its original intent. What then does it truly signify?

According to Professor Clayton Christensen, who first coined the term, disruptive innovation is something that “transforms a complicated, expensive product into one that is easier to use or is more affordable than the one most readily available.” Consequently, for an innovation to be categorized as “disruptive”, a principal criterion is not just the quantum of technological jump, but also the scale of people outreach.

Applying the above definition, does Kellton Tech’s contribution to project mSehat qualify to be termed as a “disruptive innovation”? Let us discuss this point from the perspective of inclusive healthcare. mSehat, a SIFPSA initiative, aimed at reducing the maternal-infant mortality rates in Uttar Pradesh, India, by empowering the rural frontline health workers with mobile-based solution (mHealth solution).

mSehat as a Case Study in a WHO Report

Incidentally, mSehat has been featured as a Case Study in a World Health Organization (WHO) report. Entitled “Global diffusion of eHealth: Making universal health coverage achievable, this third global survey of the WHO Global Observatory for eHealth (GOe) investigated how eHealth can support universal health coverage (UHC). In this post, we will briefly discuss how mSehat has upped the ante by reaching new levels of healthcare inclusion in the march towards UHC.

The report identifies multilingualism is a fulcrum upon which stands the “equity agenda that underpins UHC”. It further observes: “A national multilingualism policy or strategy promotes linguistic diversity and cultural identity, and reflects a government’s commitment to inclusion of linguistic minorities in the country.” This assumes significance because semi-literate people form the mainstay of frontline health workers. For these workers to deliver effective healthcare to masses, the solution must be designed in such a way that they are able to harness its power to full potential.

eLearning leading the way to mHealth

eLearning too, therefore, plays a key role in training these workers to use digital technology for the benefit of people. Since the target beneficiaries and on-ground implementers (health workers), the key stakeholders, belong to semi-literate strata of society, the learning aids and methodology must reflect that and build upon that understanding.

As capabilities of mobile technologies to handle audio-visual media increase and become affordable, text-based delivery of information can be supplemented with more engaging media,” the report notes. Indeed, for mSehat the medium of delivery content is Hindi, the regional language of Uttar Pradesh. The healthcare content is supplemented by video-aids that lend themselves to easy usage and consumption by the key stakeholders.

Once the entry barrier has been overcome, it is only a matter of fine-tuning the mSehat platform to deliver content in various languages. Indeed, mSehat is compliant with Indian government approach viz. RMNCH+A (Reproductive, Maternal, Newborn, Child, and Adolescent Health) and MCTS (Mother and Child Tracking System). Further, it is capable of handling Anganwadi Workers under ICDS programme of Government of India.  The solution can be replicated and extended throughout the developing world, given their shared problems and vision.

A major concern involving legal compliance is also readily addressed in light of its adherence to Government of India approach. Given the use of fluid digital technologies, mSehat is fully-capable of scaling up its compliance requirements to prescribed level much faster than others.  

eLearning ... is increasingly recognized as one of the key strategies for health workforce training,” the report observes.  The program involved the uphill task of training over 10, 000 rural frontline health workers to utilize this smartphone-based solution for their daily duties.  mSehat enabled these digitally-empowered workers to serve vast sections of rural population. Additionally, over 2000 people belonging to a spectrum of officers and SIFPSA staff were trained in use of tablets, enabling them to engage in near real-time monitoring of frontline workers.

Is mSehat truly a disruptive innovation in mHealth?

Let us return to Professor Christensen’s description for a moment:  what distinguishes “disruptive” from other kinds of innovations is in the way an offering is made accessible to a whole new population, which was previously available to only the elite few.  

The WHO report reaffirms: “mSehat [is] currently the largest mHealth implementation in the world in terms of population served”. Indeed, mSehat made a historic leap when it touched over 12 million people and positively impacted over 2 million beneficiaries (and the numbers continue to improve). It exemplifies how digital technologies can be infused into a public healthcare system to bring transformational change in the health outcomes of a target group.

As the report emphasizes, an unexplored territory was charted with great success: “There was no precedent or prior programme information to leverage, either locally or internationally, as no programmes have previously worked with such large volumes of government data or catered to as many users. ….The real challenge was implementing it in the “heat and dust” of India”. As to the last point from the report, among other concerns, the solution was also successfully optimized to overcome the problem of poor internet connectivity in rural areas.

mSehat, apart from involving a tremendous uptake of digital technologies, touched vast sections of rural population like no initiative before could. Therefore, it fully deserves to be termed “disruptive innovation”.