~ By Aman Shrestha.
18 pregnant women from Dandagaun Village of Rasuwa district have accessed internet from their mobile at first time to download periodic information related to their pregnancy situation. After the introduction of the"Amakomaya" an android based mobile application in 10 different villages of Rasuwa, Nuwakot, Kaski and Myagdi districts more than 350 married women have been encouragingly registering downloading and exchanging pregnancy related content from the internet. Binod Poudel, from Dandagaun village of Rasuwa District have purchased android mobile set in NRs 6,000 (US $60) only to use the "Amakomaya" android application for her wife.
Binod said Amakomaya application have increased the value of his mobile in his village and specially in his family. The project team leader, Mr. Rajendra Prasad Poudel said, "Amakomaya has encouraged women from the underserved area to come online" . Nepal has reached 73% of mobile penetration but access to internet connection is limited upto 27%. Applications like "Amakomaya" has been motivating women to access the internet and get benefited from it.
"Amakomaya" that started its initial work from 2011 with the small community grant provided by Internet Society (ISOC) under Next Generation Leadership (NGL) program to develop "www.amakomaya.com" web application and later on extended to develop localized android based mobile application by grant support of ISIF Asia have lunched formally on 3rd October, 2013 in Ramkot Primary Health Center (PHC) of Kathmandu district by providing 2 android mobile devices for the uses of FCHV during their door to door visit to pregnant women houses. Both the web and android application provides pregnancy related information in video, audio and text format. The contents are basically aimed at rural pregnant women. So, all the contents are localized in Nepali language with the intension to let rural populace with minimum level of education or even illiterate, understand these contents.
The program was attended by director of District Health Office (DHo) Administrative Division of Public health, Mr. Shree Krishana Bhatta, Head of Department (HoD), Prof. Dr. Rajendra Wagle Department of Community Medicine and Public Health, Institute of Medicine (IoM) Tribhuwan University (TU), HOD of Gynocology and Abstetric, IoM, TU Prof. Dr. Neelam Pradhan, and team leader of"Aamakomay" project, Mr. Rajendra Prasad Poudel, local health workers and FCHV together with local political leaders. In the program, Prof. Dr. Neelam said that "MMR is very high in Nepal. Many Nepalese mothers die untimely due to lack of knowledge about pregnancy. So the contents in the application will make the pregnant women aware not just about the how the development of baby takes in their body, but also about dos and don'ts during pregnancy period. Ultimately, the contents will help reduce high MMR in Nepal." Similarly, Dr. Wagle said that "I studied about pregnancy in Ramkot and places near it during my PHD degree. I found that, poor, illiterate and distant populace deliver their babies at their home and comparatively well-off and literate populace deliver baby at health institutions. So, I thought of doing something about the situation. When Aamakomaya team approached me I thought it is a golden opportunity to do something for the community.
So immediately I contacted Mr. Shree Krishna Bhatta, DHo of Administrative Division in Public Health Office to implement this project as pilot in Ramkot PHc. With the joint efforts, among University, Amayakomay team and Kathmandu District public health office have now been able to implement the program first time in Ramkot." He added that, "Maternal health is a very critical issue. The recent data shows that MMR is 229 per 100,000 and neo-natal death is 33 per 1000 live birth, which is very high compared to other countries. Though government has planned to incorporate technology and ICT in Safe Motherhood program, it is the first time android application for pregnant women is being introduced in Nepal as m-health. It will ease the communication between rural pregnant women and health workers. The role of health workers and FCHVs will be very crucial to effectively distribute the information to every pregnant woman in rural areas. The m-health is about pregnancy issue now but other aspects of health will also be incorporated in future."
The "Amakomaya" that was initiated after Rajendra Poudel became a Laureate of Small Community Grant provided by ISOC after completing his Next Generation E-Learning Program (NGL). He was then able to develop a web application with the help of university interns' programmers. The web application was piloted and tested in several villages of Myagdi district with other encouraging activities such as distribution of shawl with logo of Amakomaya.com for pregnant women. . After the experience of a year, the team noticed that web based application is not able to reach in large numbers of rural women due to many challenges. So, with the additional grant from ISIF Asia, the "Amakomaya" team were able to develop an android application with the similar features of the web based application.
The amakomaya android application not only provide educational and motivational contents to rural pregnant women, but also connects rural health workers with urban based hospital doctors. The application provides pregnancy stage relevant contents to pregnant women after they enter their Last Menstruation Period (LMP). The application is still in final development stage. After the application is fully developed, the pregnant women will be able to send queries in recorded audio format. The queries will be sent to local health post and urban based hospital doctors. The queries will be answered by health post workers, but in-case they are able to answer; they can contact urban hospital doctors to get the answer. This system will connect urban and rural health workers with rural pregnant women. It will enhance medical knowledge in rural health workers and digital knowledge in rural pregnant women. The system has the potentiality to introduce new and technological solution to effective health management information system.
The amakomaya project is a perfect example of "small initiative that ignites the flame of big change." A project that was initiated after small grant award has now grown big and gained the support and cooperation of government of Nepal, Teaching hospital doctors, local leaders and grass-root level health workers. The lunch of the program is just a small step towards triggering a big change in maternal health in Nepal.