Digital Diary Tool Under Health Account Assessment For Community Participation And Action: An Implementation Experience From Rural, Urban And Tribal Field Sites In India

Abstract

Background: Community participation and education during health data generation is missing and leading to compromised authenticity, utility of data at grass root level in India, hence module of Health Account Scheme-HAS been formulated at ICMR. Objective: Field trial of acceptability and utilisation of HAS. Methodology: Implementation research in cohort of 500 households at difficult areas (tribal, rural) with health diary and monthly updating in place for one year. Pre and post term surveys conducted for acceptability and comparison of pre and post morbidity pattern. Findings: 7484 individuals enrolled (98% acceptance) from 1500 household in rural urban (Uttar Pradesh), tribal (Arunachal Pradesh) block of 500 households at each of 3 sites. Pre and post term survey with health diary in use for one year and individuals/ health volunteers/ HAS staff updating it on monthly basis showed decrease in communicable diseases by 4%, addiction by 8%, 12% newly detected cases of previously undiagnosed cases of non-communicable disease. Gaps in health care delivery unknown to local system were detected and sorted using local resources. Conclusion: Unmet need exist in the community and participation is the key to address gaps of authenticity, education and service delivery. Recommendations: HAS module and increased skilled health care workers have potential for strengthening of health program delivery and utilisation.