Khushi Health: Data-Driven Response to COVID-19 in India

Khushi Health is a digital health platform designed to 1) empower community health workers with offline mobile health tools to screen, refer, and follow-up with COVID-19 symptoms, comorbidity, vaccine schedules, and adverse events and 2) empower health officials with GIS-dashboards and automated communication platforms to deliver targeted, scalable responses.

Saachi Dalal - Chief Strategy Officer at Khushi Baby

As of April 2021, India leads the world in new COVID-19 cases with over 180,000 new cases a day (and rising). (Rajasthan Cumulative Cases: 380,000)

Multiple factors are contributing to the alarming spread: new variants, high population density, poor adherence to COVID appropriate behaviors, super-spreader events (elections and festivals). India's public health infrastructure is overburdened by cases in major city centers, unable to provide tertiary care. The threat of the spread extending to rural India remains large. Although India does have a decentralized health workforce to the village level to serve 70% of its 1.3 billion people, the tools used by community health workers to identify outbreaks and for health officials to respond quickly, in a targeted manner, and at scale remain limited. The public health response is weeks too slow and fails to take into account local patterns of COVID-19 comorbidity and vaccine uptake in order to proactively balance resources.

Our solution has been developed to digitally empower community health workers and governments to serve citizens at risk of COVID-19 (having medical comorbidity, lacking access to routine medicines, falling in a higher age group, living primarily in rural Rajasthan). Our solution has been designed with community health workers, in alignment with government guidelines and human centered design principles. We have conducted user interviews, on the ground feasibility studies, and held extensive feedback sessions with users and government program directors. Overall, the solution has been developed in the context of the grassroots experience our organization has gained over 5 years.

Our technology solutions for health system strengthening are catered for the Government of India and given to the central and state governments free of cost to be used for public health. 

Open Source: AI algorithms, being built in collaboration with Google AI and Singapore Management University, which identify and predict health worker diligence as well as individual and community health outcomes; we also develop public facing dashboards to present the current, anonymized, and aggregated scenario from syndromic surveillance.

Over the next one year, our goal is to implement an expanded version of our COVID-19 active surveillance platform, which will include a complete authenticated digital health census, and longitudinal follow-up across health verticals (reproductive and child health, NCD management, infectious disease surveillance) across the state. This comprehensive solution will provide local and state governments with individual and community level COVID-19 and non-COVID-19 health profiles, COVID-19 vaccination statuses and adverse health outcomes. 

Over the next three years, we plan to scale our solution, which is designed in line with national guidelines, to other states through our implementation partner, the Norway India Partnership Initiative (NIPI) based in Odisha, Jammu & Kashmir, Bihar, and Madhya Pradesh. Moreover, we have been selected by the Government of India to strengthen the current country-wide COVID-19 platform, COWIN. Through this effort, we plan to scale some of our unique features to improve data quality and data-driven action across India. 

Measurable indicators of progress: 

#community health workers: 60K

#household visits: 2.5M+

#beneficiaries screened: 14M+

#high risk beneficiaries identified: 1M+

#referrals completed: 30K+

#vaccinations completed: N/A (yet to be included) 

#vaccine related adverse outcomes: N/A (yet to be included)

Financial: Our solutions are provided to the government free of cost and we require unrestricted funding scale and improve our skills and features. 

Solutions: hiring additional personal for fundraising 

Technical: 1) Lack of quality seed / baseline data, 2) Poor interoperability between datasets from various health departments and between state and center.

Solutions: we have received in-person access to the state data center and currently request datasets and manually crowd-source missing information from local bodies 

Cultural: Our solution is disrupting a paper-based system and introducing digital technology, which may not fit in with the culture of community health workers and may present a training and utilization challenge. 

Solutions: We have employed extensive UX design principles at a grassroots level for several years, which has deepened our understanding of community health workers in rural India. We also ensure our solutions are co-designed with them to ensure maximum acceptance and utility. 

Policy: Changing bureaucracy, lengthy processing times to receive approvals, and limited access, despite a legal contract as technical support partner, delays out timelines. 

Solutions: 4 members actively working at the Department of Health and lobbying at the Health Secretary level to ensure due follow-up

Formally Affiliated: 

Department of Medical, Health and Family Welfare, Rajasthan

Development Partnerships: 

NIPI (Norway India Partnership Initiative)

JHPIEGO

Google AI for Social Good

Simprints 

The Trinity Challenge will provide catalytic financial support to Khushi Baby so that we can deepen our digital tool kit for public health and scale our solutions across Rajasthan (population: 80M) and other states in India. This funding will allow us to hire the best policy level advocates, associates, and technology , and HR talent who can enable us to overcome technological and political challenges which we currently experience in Rajasthan and anticipate with every new government partnership. 

The Trinity Challenge will also connect us to a network of champions with experience in managing organization at an inflection point (like ours), handling big data sets, and working at the Central Government of India level.

We look forward to continue working with Patrick J McGovern, BMGF, JHSPH, and Google and to deepen these collaborations.

We would be interested in collaborating with 

a) IHME and Global Virome Project - to assist us in analyzing large datasets of syndromic data for spatiotemporal prediction of disease spread

b) Zenesis - we are both GAVI INFUSE Pacesetters and we can share notes on how to apply geospatial visualization techniques to drive better stakeholder engagements

c) Microsoft and Infosys - architect-level software mentorship to assist in the process of scaling up our platform

d) McKinsey and Co - to help us with organizational growth strategy, how to best apply our portfolio of digital health interventions and scale without becoming overstretched, develop innovative recurring revenue models

e) SwissRe - to understand how to apply concepts from insurance fraud to community health worker data diligence