Developing For The Next Billion — Daksh: An Intelligent Labor Monitoring Tool
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Every five minutes, at least one Indian woman dies during pregnancy and childbirth. More than 80% of deliveries occur with the assistance of staff nurses in LMICs (Low Middle-Income Countries). Most of these, staff nurses are unaware of the standard protocol for monitoring labour during pregnancy. Our founder has visited more than a hundred such healthcare settings and found that existing paper-based protocols are complicated for unskilled health workers.
Our solution, “Daksh”, helps staff nurses in monitoring the delivery and making timely interventions to save lives. It is a mobile-based intelligent labour monitoring tool which not only allows the staff nurse to register and enter the vital signs of a pregnant woman but also reminds her to monitor the labour vitals, as per the standard intrapartum protocol. It also generates alerts in case of complications, based on an inbuilt algorithm. The doctor at a remote location can also view the labour progress and guide the staff nurse. We have been piloting our solution in more than 45 government hospitals across India with positive results. We have observed an increase in protocol adherence in these healthcare settings.
The road to developing a robust solution for this novel problem was not easy. Our solution is deployed in some of the remotest areas one can ever imagine. Most of these primary health care centres have limited internet connectivity.
This. was one of our earliest challenges. Our app works in an offline-first manner. All the algorithms for complication alerts and data monitoring alarms are inbuilt into the application so that it can continue to work even when no internet connection is available. All the user actions are saved, as transactions which correspond, to certain API calls to our backend. When internet connectivity is available our applications execute these transactions by making the API calls. There is a chance that internet connectivity is lost between the time a request is sent to the server and the client receives a response. This can lead to duplicate requests to the server which could be a problem if the operations are not idempotent. To solve this, we generate a unique id for all our requests and send it to the server during the API calls. In case, the server has already executed a request with the given id it simply returns the cached response thereby solving the issue of duplicate requests.
Daksh: An Intelligent Labor Monitoring Tool
One of the main lessons which we have learned during this journey is the importance of understanding the needs of end-users. Most of the features of our solution are a direct result of very important feedback from our users. We believe that understanding the pain points of users and developing solutions to mitigate them is the best approach for product development. One such example is our monthly report feature. During our field visits, we found that Healthcare workers have to maintain a monthly childbirth report.
They were spending a good amount of time aggregating the data and preparing this report every month. In a country where staff-to-patient ratios are poor and there is already a lot of workload on health workers, this reporting task was an additional burden for them. We knew that our system had all the data for these monthly reports and doing aggregation was a trivial task. So based on this need we developed a monthly report section in our app and made it available to the healthcare workers thereby reducing their workload.
We will continue to deploy “Daksh” in more healthcare settings and use the feedback obtained to improve our product. If you are a healthcare professional and are interested in trying out “Daksh”, we have released a simplified version (with minimal important features) of our solution on the Google Play Store. You can try the “Daksh — Labor Monitoring App” by visiting this link and don’t forget to leave feedback on Play Store. Feel free to write to us at [email protected] to know more about our product. Help us improve “Daksh” and help us save lives during birth.
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