Mother, Child and the Poshan Tracker

The Poshan Tracker app helps improve last-mile delivery of nutritional services and could be a precursor for targeted investments in healthcare for women and children.

Poshan Tracker App

• The rollout of the Poshan Tracker by the Government of India represents the largest mobile phone nutrition monitoring system in the history of global health.
• Other examples of app-based nutrition monitoring systems from around the world have been limited one-off pilots with little, if any, integration into national systems.
  • For example, UNICEF’s RapidSMS project in Malawi or a small project in nine primary health centres by university researchers in the Republic of Mauritius.
• In contrast, in India, within two years of the inception of the Poshan Tracker, there has been universal uptake — nearly 3 million Anganwadi workers have downloaded the app across all states and Union territories and are using it every day for monitoring ICDS services.
• Central to the new Poshan 2.0 guidelines released by the Ministry of Women and Child Development, the Poshan Tracker is a centralised ICT-enabled platform, developed to promote transparency and accountability of nutrition service delivery to the last mile.

Data Monitoring through Poshan Tracker App:

• Going by the scale of operations, Poshan Tracker represents an unprecedented opportunity to monitor progress in addressing malnutrition in India.
• As per the latest data from the Poshan Tracker Dashboard, the height and weight of 72 million children under five years of age are being collected through the Poshan Tracker.
• If we compare it against a total of 113 million, which is the population of children under the age of 5 as per the UN Data Projections, this translates into real-time monitoring of more than 50 per cent of children in the country. Moreover, 94 per cent of beneficiaries have been Aadhar verified.

National, State and District Level Data level Monitoring:

• In addition to capturing beneficiary data, the Poshan Tracker dashboard captures national, state and district-level data on three sets of indicators.
• First, the Anganwadi infrastructure including the number of Anganwadi centres built, with functional toilets or drinking water and whether they have been open for service delivery.
• Second, tracking the number of beneficiaries who received take-home rations (not raw rations) and hot cooked meals.
• And third, monitoring of nutritional outcomes.

Significance of Poshan Tracker App:

• The Poshan Tracker is designed to act as a real-time feedback loop for frontline functionaries to prevent malnutrition by identifying children who are faltering at an early stage, targeting beneficiaries facing acute malnutrition, and monitoring the effective delivery of ICDS services.
• The various modules available on the Poshan tracker include —
  • Beneficiary registration
  • Daily tracking job aid module and home visit scheduler for the anganwadi worker
  • Growth monitoring (height/weight) as per WHO Standards
  • Migration facility for beneficiaries who move to another Anganwadi centre within or outside the state
  • A dashboard for monitoring key performance indicators of selected underperforming districts
  • A portal for reporting community engagements on nutrition promotion.
  • Further, separate modules for AWCs in tribal and border areas are also being developed.

Challenges in Poshan Tracker App:

• Looking at the global experience, doubts about data quality have been identified as a major hindrance to using nutrition monitoring data for informed nutritional policies.
• Also, global experience shows that decision-makers do not place a high value on data that are three to five years old.
• Novel approaches such as the Poshan Tracker may be a solution, but the question is: Will the Poshan Tracker improve the accuracy and timeliness of nutrition monitoring in India?

Accuracy of Poshan Tracker App data:

• With regards to accuracy, a 2015 evaluation of a mobile phone app built into the existing national growth monitoring system in Indonesia found that the mobile phone app improved the accuracy of growth monitoring for children – particularly underweight – by 80 per cent, on average.
• In the context of the Poshan Tracker, the app automatically calculates whether a child has low height for age (“stunted”), low weight for height (“wasted”), or is underweight based on the WHO growth charts.
• Thus, it has significant potential to reduce errors in manual calculation of these nutritional outcomes using field tables.
• Moreover, the granularity of Poshan Tracker data is key in addressing the huge variability in malnutrition rates estimated through household-level surveys.
• The Poshan Tracker makes beneficiary-wise data – that is observed on the ground, not modelled by academics – available for decision-makers for local and timely action.

Way Forward:

• It is important to consider the fact that Anganwadi workers are overburdened, and extreme care must be taken to ensure that the Poshan Tracker is routinely updated based on their feedback to improve user-friendliness.
• Ongoing skill-building and technical assistance will also be needed to ensure the sustainability of this new monitoring system.
• India’s Poshan Tracker represents a groundbreaking initiative in monitoring the nutritional status of women and children on a large scale.
• Nevertheless, it’s crucial to understand that data serves as a tool, not a goal in itself.
• Therefore, adequate investments must be directed towards delivering essential services when malnutrition is detected in children or mothers.
• To fulfil the objectives outlined in Poshan 2.0 guidelines, the Poshan Tracker’s data can thus catalyse tangible and actionable outcomes at the grassroots.