A Time and Motion Study on Auxiliary Nurse Midwives (ANMs) conducted by the Administrative Staff College of India (ASCI) for Andhra Pradesh led to a Mobile App, ANM Digi, the one stop solution for ANMs. ANM Digi, designed and developed by ASCI in partnership with a Visakhapatnam-based IT solutions company, 3 il Technologies, was launched by the Hon’ble Chief Minister of Andhra Pradesh Shri Nara Chandrababu Naidu in the presence of the Health Minister Shri Kamineni Srinivas and Principal Secretary, Health, Smt Poonam Malakondiah on March 6, 2018. The CM also announced bicycles for ANM to reduce the time and efforts taken in travelling long distance.
The AP Government has done away with 42 registers based on ASCI’s study that had covered 120 ANMs in Rural Primary Health Centres and Sub-Centres of three districts of Andhra Pradesh, Visakhapatnam, Chittoor and Guntur from July 2017 to September 2017.
ANMs are village level female heath workers and are the grassroot level workers who are the first point of contact between the community and the health system. Their work involves providing basic healthcare services mainly for maternal and child health, family planning, nutrition and immunization programmes.
ASCI team had studied the diverse activities of the ANM posted in PHC/Sub-Centres and time spent in each group of activities so that the wasteful/redundant activities can be removed for their better utilization.One of the key findings of the study was, ANMs were spending more hours at work than the stipulated seven hours of duty but the concern was the nature of activities which took their time. Out of total time in a day, on an average 39.36% of their time was spent on administrative activities (2.83 hours/day as compared to an average 25.14 % of time spent on Clinical activities of 1.81 hrs/day). Administrative activities largely included filling registers and reports and travelling to houses for providing care.
There were 42 registers which ANM had to fill! They were carrying both the Tablet Anmol (supplied by the Government for reporting but covering only partial programmes) and 42 registers on ground, thus resulting in duplication of work and causing difficulty in transport and additional workload. Also, there was no standardization in the registers followed in all districts with adhoc, multiple and duplicate entries made in registers. To reduce ANMs' time used in administrative activitiesOPTIMIZATION and STANDARDIZATION STUDY of the records and registers of ANMs was done to avoid duplication.
ASCI’s Professor Dr.Bhawna Gulati said: “ANM Digi isthe one stop solution for ANMs for all reporting purposes with special features focussing on ease of use and easy retrieval of data. An academic exercise was completed with tangible results and Outcomes with definite improvement in quality of work, better utilization of ANMs time at Grass root level and improved clinical care.”
She also said that ASCI along with IT Partners could remove 42 reporting registers and make paperless reporting possible at grass root level in entire State of Andhra Pradesh. “Thus, the ANMs time could be better utilized focussing on Clinical care,” Dr.Bhawna maintained.