To be - Fitmom

Two Lives Twice as Precious, Act now!

Problem

1. Unplanned pregnancies make simple proactive interventions become impossible in 4-5 out of 10 women
2. Perinatal deaths are 50% higher among babies born to adolescent mothers
3. 25% of pregnancies are complicated by hyperglycemia in South East Asia
4. Nutritional  and iron-deficiency Anemia is present in 50-60% of women in reproductive age group and accounts for 20% of maternal mortality
5. With no interventions, rates of HIV transmission from mother to child are between 15 and 45%
6. Mental health issues from stress to depression are increasingly prevalent in reproductive age women

Solution

“Preconceptioncare (PCC)” is the provision of biomedical, behavioral and social health interventions to women and couples before conception occurs.

It aims at improving the health status of women from all socio-economic backgrounds by reducing unhealthy behaviors, while addressing individual and environmental risk factors that contribute to poor maternal and child health outcomes.

The Four key steps in Preconception care include:

1. Holding a dialogue regarding a Woman’s readiness for pregnancy
2. Evaluation of her overall health and opportunities for improving it
3. Education about the significant impact that social determinants, behavioral, and genetic factors have in pregnancy
4. Identification of women at high risk for an adverse pregnancy outcome

Tobe-Fitmom

A clinician-designed interactive App/web based application to support all moms to be, called “Tobe-Fitmom”, will be developed.

1. This app will define a one of its kind process, which will be used to capture the data
2. It will take the user through a 15 point checklist that will address factors like Anemia, health history, nutrition etc, influencing women’s health in their reproductive years 
3.  The app will suggest counselling, screening, medical/ lifestyle interventions like smoking cessation, vaccinations etc., based on the data captured

Innovative channels will be used to reach women from 18-40 years

1. DIWWAAAS network of Physicians
2. Workplace wellness programs
3. NGOs and Clubs
4. Educational institutions
5. The Public Health System

A simple training tool and instructional video will be made available, on how to use the “Tobe-Fitmom” app, to capture data and suggest follow-up interventions

A preliminary analysis will be done through OBGYN, workplaces, colleges to measure user experience of the app, the content and the efficiency of the web version. The user feedback will be used to fine tune the solution

The project will measure through impact studies, the increase in the number of people seeking PCC and the interventions undertaken

The number of people seeking PCC can be scaled to multiple geographic areas, through partnerships and social media based dissemination.

The program can sustain itself through the partner network and the public health system, as part of standard medical practice, as it gets accepted and adopted.

Outcomes

• From “Healthy mother to healthy baby”, there will be a paradigm shift of “Healthy woman to healthy mother to healthy baby”
• Promoting behavior change from  treatment-seeking to Wellness-seeking
• Put women on a healthy trajectory for life
• Generations to come will be healthier and physically and emotionally fit to seek institutional pregnancy care

1. In India, National health programs exist for adolescent health, safe motherhood and new-born care. However, the crucial period of preconception remains neglected
2. Preconception care is a huge unmet need: if incorporated into standards of care could significantly reduce maternal/infant mortality and lead to dramatic reduction in health costs for future generations
3. Tobe-Fitmom is a unique process to solve health challenges like perinatal deaths, hyperglycaemia during pregnancy, anemia, HIV, mental, psychological problems and has a positive impact on range of health outcomes like birth defects, child cancer etc 
4. Tobe-Fitmom leverages existing public health networks and technology facilitation

1. Tobe-Fitmom  is a mobile/web app and is an inexpensive way to provide high quality services, giving greater flexibility for the physicians and easy access for women of reproductive age who are tech-savvy
2. The entire program involves minimal/no training for the end users
3. The app will store data in a cloud server which can be accessed, anytime anywhere
4. Mobile technology will be used which can be very useful to provide care in remote rural locations
5. The generated data can be analysed through Artificial Intelligence (machine learning)

1. To do a situation analysis of Knowledge Attitude and Practice (KAP) of Preconceptioncare (PCC)
2. Recognising and addressing barriers to the utilization of PCC
3. To ensure more women use the app and become physically, emotionally fit to endure pregnancy and labour, to avail ante-natal, institutional delivery and new-born care
4. To reach 1,000,000 people and train 10,000 physicians in 12 months
5. To make it applicable across the socio- economic spectrum particularly to low resource settings where the benefits can be transformative
6. To promote health and wellness across the reproductive continuum through women themselves

1. Over a 3 to 5 year period with a 100 to 150 million deliveries in India, even a small 5% impacted translates to 5 million women. Our goal will be to reach this
2. The solution can be scaled to other countries through partnerships, who can inturn reach out to people in their communities. Our goal will be to reach 5 countries outside India in the next 5 years
3. As the solution gets integrated with standard medical practice after it gets widely accepted and adopted, it can impact greater number of people over time

1. The beneficiaries would be reached through innovative delivery channels like network of physicians, institutions, public healthcare, workplace wellness, NGOS and clubs, peer to peer social media networks
2. The solution will be a mobile app which can be used by the Physicians to administer the program 
3. Based on individual patient data the app will direct to various interventions 
4. The customers will be retained by suggesting followup mechanisms  to receive continuous care
5. The data entered will be transmitted through wifi or mobile network into centralised servers in Cloud, with data backup and security

1. Currently 1000 physicians pan India, are using the To be-Fitmom solution and they serve a community of 100,000 people
2. They have been trained by an expert group of 100 endocrinologists and diabetologists
3. These 100,000 people are registered for the program and are following the program advice
4. These Physicians currently use the paper method to capture information from the target group and suggest interventions
5. In all focus groups discussions the solution is accepted very well and adopted

1. To reach 1,000,000 people and train 10,000 Frontline Health Workers in the next 12 months
2. These people will be reached through various delivery channels and partner networks, who will use the Tobe-Fitmom app to serve the community
3. In 3 years 3,000,000 people will be benefitted
4. The target group will be females, 18 to 40 years, underprivileged rural and urban poor who are planning their pregnancies and also those who are going through post-partum care

1. Ability to reach the community through the existing network of physicians, collaborate with Public Healthcare System
2. Communication skills to collaborate with partners to adopt the program 
3. Project Management skills to achieve Operational excellence, manage, monitor and evaluate the program
4. Subject matter experts, who are pioneers in the field of endocrinology and diabetes in women
5. Researchers in Public Health who have conducted researches in multiple disciplines of health
6. Technology  expert who has developed IT solutions in multiple domains

1. The proposed solution app will be provided free of cost to the healthcare providers
2. The solution will be sustainable in a long term as it would be integrated with the current medical practice of the public and private health care system delivery
3. The solution will be expanded by adding more partners in multiple countries, who will be able to use the app for providing the care

1. Tobe-Fitmom is a mobile/web technology based app which can impact millions of lives
2. Solve can help in connecting to its network of partners and help scale the solution to multiple countries, world over
3. Solve can provide through its network, technology innovation for scaling the solution, through cloud computing
4. Solve can provide through its network, innovation through Artificial Intelligence and Machine Learning, insights on the data that would be generated as part of this project, which can help in framing national policies

1. One of the key barriers will be the reach to communities outside India
2. The Solve community membership can enable partnerships with organizations worldwide which can help in scaling the solution and enable it to reach communities worldwide
3. Risks involved in cloud computing like Internet connectivity and security of data could be barriers in using the solution effectively
4. Innovative features to mitigate these risks will be built into the application and Solve can help with technology mentorship to achieve the same