Introduction to KMA Program.pptx.........

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1. Kilkari and Mobile Academy: an approach towards empowerment, improving skills and care

2. The Ministry of Health & Family Welfare, introduced centralized, interactive voice response (IVR) based mobile health services. Kilkari and Mobile Academy are one of the largest m-health programs globally

3. On 15 January 2016, Ministry of Health and Family Welfare, Government of India launched the national scale up of two mHealth services as part of its Digital India initiative: Kilkari and Mobile Academy Phase-wise launch of the project, was aimed with scale up the services nationally across all states.

4. Kilkari (a baby’s gurgle) is an outbound service that delivers weekly, time-appropriate audio messages about pregnancy, childbirth, and childcare directly to families’ mobile phones using IVR (Interactive Voice Response) technology. Covers the critical time period when most deaths occur – from the second trimester of pregnancy until the child is one year old (72 weeks) Delivers one pre-recorded message per week directly to the mobile phones of pregnant women and mothers with children under the age of one year. Total 72 messages FREE – Kilkari is centrally hosted by MoHFW for all states . No investment in technology, telephony infrastructure or operational costs is required by states. Integrated with MoHFW’s centralized Reproductive Child Health (RCH) portal - the only source of information for this mHealth service. Incoming Kilkari number: 0124-4451660 About Kilkari

5. History 5

6. Uses Interactive Voice Response (IVR) technology – Kilkari delivers time-sensitive audio messages (voice call) about RMNCH directly to the mobile phones of families Covers the critical time period when most deaths occur – from the second trimester of pregnancy until the child is one year old (72 weeks) Delivers one pre-recorded message per week directly to the mobile phones of pregnant women and mothers with children under the age of one year FREE – Kilkari is centrally hosted by MoHFW for all states. No investment in technology, telephony infrastructure or operational costs is required by states. Reinforce key health information to the beneficiary and her family by the frontline health worker Time sensitive – relevant to the woman’s stage of pregnancy Integrated with MoHFW’s centralized Reproductive Child Health (RCH) portal - the only source of information for this mHealth service. Incoming Kilkari number: 0124-4451660 About Kilkari

7. How to access Kilkari A pregnant woman or a mother with a child under the age of one year registers her pregnancy with the Auxiliary Nurse Midwife (ANM). Her data (including a valid mobile number and her expected date of delivery or child’s age) is entered into the MCTS/RCH portal by the data entry operator at the block level. The woman is now registered on the database and begins receiving one audio message every week on the registered mobile number, linked to her stage of pregnancy or child’s age. The audio messages received are based on her Last Menstrual Period (LMP) or her child’s Date of Birth (DoB), entered into the RCH portal If a woman misses her weekly call, the IVR system automatically tries to call her three times on the same day and then twice for the next three days. Alternatively, If the woman misses a call from Kilkari or wants to re-listen to that weeks message, she can dial 14423 to hear it again.

8. Kilkari audio messages are presented in the voice of a fictitious doctor character called Dr Anita The information she imparts in each message comes from doctors and specialists at the MoHFW and NHSRC (national health systems resource center) Her tone is authoritative, yet sympathetic and designed to inspire confidence in the listener She is a friend, philosopher and guide to the frontline health workers and the families she serves Dr. Anita

9. PPFP PPIUCD Encouraging adoption IUCD 2 types Test for pregnancy Limiting Male sterilization Female sterilization Spacing Oral contraceptive pills Condoms Emergency contraceptive pills JSSK pregnant woman ANC Birth preparedness Quality of food for pregnant woman Anemia TT & IFA Rest for pregnant woman Institutional delivery Preterm delivery Home delivery Ambulance service Danger signs for expecting mother Breastfeeding Thermal & cord care Danger signs new baby JSSK child General childhood diseases prevention RBSK & development milestones Pneumonia & Malaria Diarrhea Growth monitoring Anemia Iron for child Complementary feeding Safe drinking water & hygiene Immunization need Compliance Zero dose First dose Second dose Third dose Fourth dose Fifth dose Kilkari Technical Health Content

10. Kilkari journey so far.. . Phase 1 (Jan 2016 to Dec 2016) Launch in Uttar Pradesh, Jharkhand, Odisha, Uttarakhand, Madhya Pradesh (only 17 High Priority Districts (HPDs), Rajasthan (only 10 HPDs) (Hindi and Oriya versions) Phase 2 (Jan 2017 to Dec 2017) Launch in Bihar, Himachal Pradesh, Chhattisgarh, Haryana, Assam and Delhi Remaining districts of Madhya Pradesh and Rajasthan covered (Hindi and Assamese versions) 2018 West Bengal launched on 26 th February, 2018 ( Bengali version) 2021 Launch in Jammu(5 th Apr, 2021) and Kashmir(1 st Apr, 2021) (Hindi version) Launch in Chandigarh and A&N. Soft launch done in Tripura in March’21 2022 Soft launch done in Andhra Pradesh on 31 st March’22 (Telugu version). Formal training and launch has been done in AP in May’22. The formal launch has done in Andaman & Nicobar Island in May’22.

11. Some glimpses of Kilkari program across states 11 House to house Kilkari visits by ASHA, ANM, Anganwadi workers and CHO in Kesinga block, Kalahandi district (Odisha) Sensitisation of beneficiaries, ASHAs, and Anganwadi workers at UHND session in Shahpur Jat (Delhi) Awareness generation for Kilkari call through wall paintings in Venkatershwara Puram, Nelluru District (Andhra Pradesh)

12. Awareness generation about Kilkari calls at the VHSND sessions, Narayanpur District (Chhattisgarh) ASHA and ANM meetings on Kilkari & Mobile Academy in Katihar district (Bihar)

13. A reproductive maternal neonatal and child health (RMNCH) mobile-based training course designed to refresh frontline health workers’ knowledge of life-saving preventative health behaviors and improve the quality of their engagement with new and expecting mothers and their families.

14. About Mobile Academy The course is 240 minutes long 11 Chapters, each chapter has 4 lessons (44 lessons in total) At the end of each chapter there are 4 quiz questions – ASHAs have to choose between 2 possible answers Once the ASHA completes all 11 chapters and quizzes, she gets an SMS with her final score and a unique ID If the ASHA scores a total of 50% and above in the quiz she qualifies to receive a certificate of recognition from the Government – this builds her motivation, confidence and self-efficacy All that the ASHA has to do is dial 14424 from her registered mobile and she can start the course

15. How to access Mobile Academy STEP DETAILS STEP 1 ASHA to dial 14424 from the registered mobile phone to start the Mobile Academy course STEP 2 Listen to the WELCOME MESSAGE carefully to understand the instructions on ‘how to do the course’ STEP 3 After the welcome message: Press 1 to LISTEN AGAIN to the welcome message Press 2 to START the course STEP 4 LISTEN TO CHAPTERS, LESSONS AND FINISH QUIZZES To navigate: Press 1 to REPEAT the same chapter/lesson Press 2 to go to NEXT chapter/lesson STEP 5 At the END of the chapter 11, PRESS 2 to listen to your FINAL SCORE Do not disconnect until the final prompt is over – until the recorded voice stops talking

16. Mobile Academy: Certificate

17. Mobile Academy : Benefits

18. Hand washing Stopping open defecation Birth preparedness Antenatal care Safe delivery Postnatal care Family planning Routine immunization Complementary feeding Identifying and preventing malnutrition Preventing childhood infectious diseases (Diarrhea, pneumonia and malaria) Newborn care Immediate breastfeeding Exclusive breastfeeding Mobile Academy Technical Health Content

19. Mobile Academy journey so far Phase 1 states 2016 Launched in Jharkhand, Uttarakhand, Madhya Pradesh and Rajasthan (Hindi version) Phase 2 states 2017 Launched in Bihar, Himachal Pradesh, Chhattisgarh, Haryana, Assam, Odisha, Uttar Pradesh and Delhi (Hindi, Assamese & Oria versions) 2018 Launch ed in West Bengal ( Bengali version) 2021 Launched in Jammu(5 th Apr, 2021) and Kashmir(1 st Apr, 2021) (Hindi version) Soft launch done in Tripura in March’21 (Bengali version) 2022 Launched in Andhra Pradesh in May’22(Telugu version) and in A&N islands in May’22 (Hindi)

20. Kilkari & Mobile Academy 2.0 Richer multimedia content including videos, digital posters/images, audio, quizzes and interactive nudges. Multiple delivery channels such as WhatsApp, YouTube, dedicated app, etc. (in addition to IVR) that will enable technology-enabled two-way communication and handholding Targeted messaging with information about high-risk conditions for pregnancy and infancy Address equity challenges with respect to access to health services through measures such as handholding through frontline health workers, self help groups and call centre To serve women with differential access to technology and varying health needs & social locations, we want to move from a one-size-fits-all approach to a fit for purpose approach

21. Kilkari 2.0

22. Mobile Academy 2.0

23. Using predictive analytics low listeners can be identified by the system and targeted interventions can be done to improve their engagement. ASHAs can be notified about subscribers listenership behaviour and handholding support can be provided to improve their listenership Call centre can be engaged to promote listenership or help them get their issues addressed for improved listenership Listenership behaviours can be identified using call data for offering listenership preferences such as call timings, preferred content etc. Background Around 44% of Kilkari subscribers are low listeners Eventually they are deactivated by Kilkari system due to low listenership Low listenership can be due to several reasons ARMMAN has started working with Google team for using AI in Kilkari and Mobile Academy for predictive analytics, listenership behaviours (content likelihood, time preference etc. for improved listenership experience) Use of Artificial Intelligence in Kilkari and MA