Rationalising the Auxiliary Nurse Midwife (ANM) service delivery register (SDR) was a key intervention within the Akshada program in Rajasthan. The Antara Foundation rationalised the ANM SDR with a view to reduce workload without losing important information, thus freeing up time for service delivery. By eliminating redundant and overlapping data-recording, this exercise also helped in bringing role clarity among the frontline workers of Rajasthan.
The new register was intuitive, and process driven, including all the critical design innovations. In November 2016, the updated register format was finalised with the Department of Health and Family Welfare and the new registers were printed and circulated. Since Mar 2017, the ANMs have been using the rationalised registers across the state of Rajasthan.
The ASHA (Accredited Social Health Activist) worker delivers critical services to beneficiaries at their household, however she is unable to prioritise her work. In 2016, ASHAs of three blocks were provided with a household visit scheduler on a pilot basis. The scheduler was designed with an algorithm that enabled the ASHA worker to schedule visits in advance based on service priority. Regular services were included into the scheduler as well so no beneficiary would be missed. In 2018, the ASHA household visit calendar was added to the ASHA diary as an addendum and scaled throughout the state of Rajasthan.
In August 2020, the revised ASHA diary was accepted by the MP government for scale-up across all 52 districts of the State. This intervention will benefit more than 64,000 ASHA workers state-wide.