Due to India’s three-tier public health system, there are different levels of trained medical personnel [Auxiliary Nurse Midwife (ANM), Medical Officer (MO), and Specialist] present at various health facilities. A pregnant woman within the public health system avails prescribed care during pregnancy at different facilities (sub-centers, primary health centers, community health centers, rural/sub-district hospitals, and district hospitals) by different personnel.

There is a lack of training modules to help the ANMs and MOs in the early identification of antenatal women with high-risk conditions and there are currently no standardized protocols across the country clearly outlining the responsibility of an ANM, MO, and Specialist for the management of women with high-risk pregnancies.

Amma-Kosam is a smartphone application that will be used by ANM, Medical Officers, and Gynecologists which offers them the ability to access both medical knowledge and patient data at the point of care, in almost real-time. This training app allows them to improve their knowledge and skills continually, at their convenience. At this time the app is for the use of ANM, Medical officers, and gynecologists in the State of Telangana only.

The aim of the Amma-Kosam is to train health practitioners (namely, auxiliary nurse midwives, medical officers, and specialists) at each level of India’s three-tiered healthcare system to:

1. IDENTIFY: Identify high-risk pregnancy conditions as early as possible
2. TEST & TREAT: Conduct all the necessary tests and treatment at each level of the health system as required
3. TRANSFER: Transfer the high-risk pregnant woman up and down the three tiers in a seamless manner without loss of data, in a timely manner and as efficiently as possible so as to ensure the best possible health outcomes for the woman and her baby
4. Follow-up periodically to ensure that the risk factors are being managed and refer such cases which are treatment-resistant or non-compliant.

In order to see real change in maternal and infant mortality and morbidity, ARMMAN in collaboration with Argusoft has developed dual-purpose application smart devices that will enable the health practitioners to track and record data for each pregnant woman with a high-risk condition and to continue to learn and refresh their knowledge of the high-risk pregnancy protocols.

The Learning management system app will consist of videos, simulations, training presentations, and two-way communication so that the health workers and practitioners can revisit the training and upgrade their skills as required. This is coupled with a tracking app where all these protocols will be turned into decision support algorithmic tools that will handhold the health worker through symptoms, signs, diagnostics, management, treatment, and counseling, ensuring early identification and end-to-end management of high-risk pregnancy conditions. The idea is to create a learning environment that supports the healthcare practitioners at every level of the healthcare system to be able to support the health needs of every pregnant woman.