With the inability to closely follow-up on women during their pregnancy period impairing its ability to bring down maternal mortality rate, the State government has rolled up its sleeves to address the problem.
The solution, here too, seems to lie in technology. The Directorate of Public Health has commissioned the use of the Pregnancy Infant COHORT Monitoring Evaluation (PICME) software for all staff members, primarily in all primary health centres (PHC), and for outreach workers.
The software is calculated to keep tabs on the mother throughout her ante-natal period and the child until the age of one year, R.T. Porkaipandian, Director of Public Health, has told The Hindu.
By ensuring that the mother is followed up right through the term, and the child for a year, there is a better guarantee for the health of both, he explains. “If we are able to make sure that the mother gets all the required check-ups and health care during the pregnancy period, safer deliveries and healthier children are likely to be the result in the long run.”
The inability to track the mother right through using conventional systems lies in a cultural practice in Tamil Nadu, explains K.Vanaja, joint director (immunisation). “Here, women have the practice of going to their maternal house during pregnancy. Some women also shift frequently between the husband's place and the mother's. When they move, they go to different PHCs and forget to take their health cards with them.”
Without the card, which contains all health information pertaining to the pregnant woman, treatment and follow-up become inconsistent and random. Women who are in the high-risk category may not get the required attention in such cases.
PICME will generate a unique number for every pregnant woman/mother which can then be called up at any PHC that the woman can go to. Once called up, it will generate all information relating to the pregnant woman; for instance, weight, scan results, anaemia, nutrition details.
For a year after the child is born, the little one's weight, height and immunisation details will come up on the screen. “We are sure this will make an impact on our efforts to reduce our MMR and infant mortality rate,” says Dr. Porkaipandian.
In addition, all pregnant women and mothers who have delivered since January 1 this year have been issued new health cards, duplicates of which will be stored at the PHC where the woman is registered.
All PHCs have internet-enabled computers, and in centres where connectivity is an issue, the centres have been asked to buy data cards, says Dr. Vanaja. Sustained connectivity is absolutely crucial to the success of the project, since the software is web-based.
Eventually, this will also mean the elimination of bulky patient registers in the PHCs. “At one time, there used to be 12 registers at a PHC where delivery takes place. It was the nurse's duty to correlate the information across these registers and trace the mother. Now, there are nine registers,” according to Dr. Vanaja.
PICME will also store the mobile numbers of the women (or close family members) and generate text messages informing them of the dates to report at the PHC, ultra sound scan and immunisation details, she adds.




Health has been the most important part of Human life. The innovative idea will definitely help in improving the present status of MMR and IMR of TN State. Here I would like to add my view for your further strengthening the monitoring system in the area of Health and Family Welfare. As Dr. M.C. Gupta said very correctly about adding the ICDS beneficiaries in future as it has Unique Identification Number. In this six years the family is completed as per population norms. It can also be promoted for meeting the unmet needs of the married couples and further for birth spacing (condoms, pills, IUD, NSVT, TT/LTT). This will also avoid the unwanted pregnancy which lead to unsafe abortion by quacks. It can very easily be used for providing information of family planning also so that population stabilization can be targeted. Finally, I would request to all the implementor of the project to please monitor the programme very closely and keep track of the same, as most our programme fails due to this and secondly, when the implementor got transferred or has been changed from the position. One has to take ownership of the programme for making it a success. Lastly, for the policy makers and implementors, don't make it as a universal programme in India as it is successful in Tamil nadu. Most of our programs fail due to universal implementation of projects.
This initiative sounds promising but efficiency will not be as expected. There are existing reporting system and it has its own drawbacks, I hope this new project address that issue than introducing new issues. Government officials spoke on defending the project. @Gupta: TN is doing really well because other states way behind.
This is highly commendable and imaginative and seems to be workable.Tamil Nadu is a progressive state and maybe this step will help it rise further. It will be highly desirable that the project is linked with the Unique Identification Number project. It may also be extended later up to 6 years age to link it with the ICDS [Integrated Child Development Scheme] project.
Dr. R.T. Porkaipandian, Director of Public Health, Dr. K.Vanaja, joint director (immunisation). Dear Sir / Madam, Please go throught this site. www.arogyamitra.com. We have already started providing services to doctors and patients from this site. Please get in touch with me so that we can discuss various other ideas regarding use of technology in public health. Dr Rajeev Joshi Director, HITECH Medical Informational Services.
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