Supporting rural healthcare in India with technology

11/13/24 • 65 min

Overview

We are joined in this episode by Ruchit Nagar, the CEO and Co-Founder of Khushi Baby. For his efforts to deliver scalable public health impact, Ruchit has been recognized as a Forbes 30 under 30 leader in Health Care, a World Innovation Summit in Health Young Innovator, and a Distinguished Young Alumnus by by the Yale School of Public Health

This episode covers into the role of India's Community health workers, or Accredited Social Health Activists (ASHAs). We hear from Ruchit's experience implementing with Khushi baby the challenges of integrating technology to support health workers.

Ruchit also gives us a lowdown on India's digital public health approach and shares his key learnings and insights for people looking to implement tech in rural areas.

We get into the challenges in policy, the data infrastructure layer and the importance of funding for sustainable health initiatives. Ruchit also emphasizes the need for better support and resources for ASHAs, the impact of technology on healthcare delivery, and the necessity of aligning incentives to improve health outcomes.

Chapters

00:00 Intro

03:53 Khushi baby origins

05:10 Challenges in Community Health Delivery

07:18 The Role of ASHAs in Healthcare

12:28 The Need for Integrated Solutions

14:14 India public health digital ecosystem 101

19:51 When "too much digital" gets in the way of good care

22:28 Pitfalls in funding and investment approaches

23:20 The 3 I's that drive implementation success

31:56 Leveraging Data for Health System Strengthening

35:53 Challenges in Health System Integration

41:35 Measuring Impact and Effectiveness

47:44 Aligning Incentives with Ground Realities

53:56 Navigating Quality, Evaluation and Regulatory Challenges

56:48 Future Directions for Khushi Baby

01:02:02 Ruchit's top takeaway for developers

References

Khushi baby website

Book reference: Poor Economics by Abhijit V. Banerjee and Esther Duflo
TB free India 2025

Like what you hear? Follow us. I'd love your feedback on what you found valuable, and what you want to see. Comment on youtube, and follow the page on linkedin.

Want to share your story? Get in touch.

Overview

Ruchit also gives us a lowdown on India's digital public health approach and shares his key learnings and insights for people looking to implement tech in rural areas.

Chapters

00:00 Intro

03:53 Khushi baby origins

05:10 Challenges in Community Health Delivery

07:18 The Role of ASHAs in Healthcare

12:28 The Need for Integrated Solutions

14:14 India public health digital ecosystem 101

19:51 When "too much digital" gets in the way of good care

22:28 Pitfalls in funding and investment approaches

23:20 The 3 I's that drive implementation success

31:56 Leveraging Data for Health System Strengthening

35:53 Challenges in Health System Integration

41:35 Measuring Impact and Effectiveness

47:44 Aligning Incentives with Ground Realities

53:56 Navigating Quality, Evaluation and Regulatory Challenges

56:48 Future Directions for Khushi Baby

01:02:02 Ruchit's top takeaway for developers

References

Khushi baby website

Book reference: Poor Economics by Abhijit V. Banerjee and Esther Duflo
TB free India 2025

Like what you hear? Follow us. I'd love your feedback on what you found valuable, and what you want to see. Comment on youtube, and follow the page on linkedin.

Want to share your story? Get in touch.

Previous Episode

Impactful digital health transformation through a clear vision and values: insights from Eswatini

Episode 6: What can we learn about creating real impact for underserved communities from The Kingdom of Eswatini, a tiny country enveloped by South Africa?

Join us on the latest episode of the Global Perspectives on Digital Health podcast where we hear from Executive Director of The Luke Commission, Echo Vanderwal about the way that set up healthcare services for those who needed it most and added digital in a way that enabled healthcare workers to deliver compassionate, high quality care.

If you want to see how to create real impact for patients who have real transportation barriers rurally, then hear about what the Luke commission have done with :

Telehealth hubs out of shipping containers with access to doctors by video, and secure vending machine for simple non controlled medications, all enabled via Starlink
Drones piloted by local staff that deliver critical but high value medications like antivenom rapidly and effectively - and the impact this has had on the people who can now survive Black mamba neurotoxic envenomation

Or if you want to learn how they:

Enabled their community health workers by creating their own bespoke EHR and admin tool that was clinician centred and based on the fastest feedback loops possible (see the clip!)
Created a culture of treating patients with compassion to overcome and the values that helped them make decisions and get through some challenging times
Used the end goal of what they wanted great healthcare to look like, and made decisions on how digital could help them get there
Proactively worked with the country’s Civil Aviation Authority to work together on how to get in place what was necessary to be safe and deliver a high quality and reliable drone service (lesson here for regulators and developers on working closely together in unchartered territory with the end goal in mind - Stephen talked in episode 5 about how the regulator could and should be a facilitator.

There’s so much insight packed into this episode - it was energising to record it to say the least and I’m really inspired by the work and impact they have had.

If you are a healthcare leader, developer or working to create impact for the people rurally, you have got to give this one a listen and share it with others who might benefit from Echo’s insights.

Links:
https://www.lukecommission.org/
https://www.luvelo.org/

Next Episode

Co-designing mental health solutions with young people in Rwanda

Implementing a digital mental health solution in Rwanda.
What does real, meaningful co-design look like?
What does it mean to truly engage with a community to develop a solution they actually use and that addresses their problems?
What incentives and mindsets allow us to, instead of 'driving' a certain technology into a context, stop and listen, and go in with no pre-conceived notion of what would be built?
How do we get procurement and policy to really value and elevate equitable solutions?

These are some of the great questions we covered in the latest podcast episode with Dr Jana Alagarajah. His wide experience, and work implementing a digital mental health tool with young people in Rwanda gives us some great talking points. Jana shares what he learned working with people and community leaders, as well as carers, and how they approached co-design and evaluation.

We also talked about his insights from working in partnership with UNICEF, USAID, the King's Fund and Health Foundation.

Dr Jana Alagarajah (MD MPH): Digital mental health specialist, UK-trained public health doctor, and psychiatrist co-designing equitable and impactful digital health innovation in Africa with young people as Technical Lead at YLabs. Partnering with UNICEF, USAID, and Gates Foundation, he leverages digital tools to strengthen health systems.

Linkedin: https://www.linkedin.com/in/janaganalagarajah/

YLabs: https://www.ylabsglobal.org/
Grand Challenges Canada: https://www.grandchallenges.ca/

Key Resources:

Design:
- Co-design: YLabs’ Youth-driven approach to digital health focussing on co-designing with youth.
- Designing for diversity: Importance of co-creating culturally adapted tech to address health inequalities in diverse populations - report from NHS Race and Health Observatory.
- Regulation: Co-developed Africa’s first evidence-based digital mental health regulation (‘HealthTech Hub Africa Digital Health Policy Blueprint 1.0’) with the Rwandan Ministry of Heath, Africa CDC, Jhpiego, Novartis Foundation covering key design elements such as interoperability, data privacy and UX approaches to meet the needs of diverse populations.
Implementation:
- Digital stigma reduction tool: ‘Prepare for a Better Tomorrow’ (Rwanda, 2021): Rwanda’s first youth-driven, holistic digital learning and peer support platform to increase mental health literacy and psychosocial support for Rwandan youth aged 10-19 years old. Funded by Grand Challenges Canada.
- Digital tools for mental healthcare workers: ‘USAID Kijana Nahodha’ (Tanzania, 2023): digital mental health education and referral tool for community health workers in Tanzania as part of a $5.4M USAID grant, impacting 140,000 youth and 250 community health workers.
Evaluation:
- Evidence generation: A systematic literature review evaluating the efficacy of digital mental health technologies for youth in low and middle-income countries: Alagarajah J, Ceccolini D, Butler S. Digital mental health interventions for treating mental disorders in young people based in low-and middle-income countries: A systematic review of the literature. Cambridge Prisms: Global Mental Health. 2024;11:e74. doi:10.1017/gmh.2024.71
- Innovative approaches to digital evaluation: At YLabs, we have utilized traditional evaluation methodologies such as cluster RCTs to evaluate our digital interventions. However, given the challenges in evaluating digital health solutions, novel methodologies, such as cyclical evaluation, can be used to maximize usability, and support integration into health systems.