Journey From a Digital Innovation to a Sustainable Health Worker Capacity-Building App in India: Experiences, Challenges, and Lessons Learned

Rebecca Chase; Sohini Sanyal; Preksha Singh; Sharda Sharda; Anita Bhargava; Pramod Raturi; Gopal Krishna Soni; Parthasarathi Ganguly

doi:10.9745/GHSP-D-24-00006

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FIGURE 1
Timeline of Conceptualization and Implementation of the RISE Learning Management System Application
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FIGURE 2
Map of RISE App Users in India, May 2024
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FIGURE 3
RISE App Learner’s Module Certificate Status, May 2024
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Narrator figure in RISE app. © John Snow India Private Limited

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TABLE 1.

Paired T-Test Results Showing Learning Effectiveness After RISE Training Indicative Through Practice Improvement Assessment in Intervention Districts in India

Correct Practices Observed	No. (%) of ANMs Practicing Correctly Before RISE Training (N=45)	X	No. (%) of ANMs Practicing Correctly After RISE Training (N=45)	X	P-Value	Net Change
1. Mark date and time after opening each vaccine vial	25 (56)	1.6	41 (91)	1.9	<.001	0.356
2. Place heat-sensitive vaccines on ice pack	23 (51)	1.5	31 (69)	1.7	<.05	0.178
3. Does not use reconstituted vaccines after 4 hours of reconstitution	42 (93)	1.1	45 (100)	2.0	<.001	0.933
4. Does not touch needle during vaccination	41 (91)	2.5	44 (98)	2.4	NS	0.044
5. Use correct route of vaccination	35 (78)	2.2	42 (93)	2.4	NS	0.178
6. Uses correct site for administering vaccines to a child	38 (84)	2.3	44 (98)	2.5	<.001	0.156
7. Cut hub of both auto-disable and disposable syringes immediately after use	38 (84)	2.2	42 (93)	2.4	<.05	0.156
8. Uses Red bag for collecting the plastic part of the syringes immediately after using the hub cutter	33 (73)	1.9	40 (89)	2.1	NS	0.222
9. Update maternal and child protection card and counterfoil immediately after vaccination	10 (22)	0.6	39 (87)	1.9	<.001	1.289
10. All 4 key messages given to the caregivers	14 (31)	1.0	26 (58)	1.1	NS	0.089
11. Ask the caregivers to wait for 30 minutes after vaccination	10 (22)	0.7	35 (78)	1.5	<.001	0.800

Sample health workers (N=45) in the intervention districts.
Abbreviations: ANM, auxiliary nurse midwife; NS, not significant.

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TABLE 2.
Phased Scale-up of RISE in India
Phases Target States Target Districts Target Learners
Pilot Phase (2017–2020) 5 5 2,800+
Scale-up Phase 1 (2021–2022) 3 33 12,500+
Scale-up Phase 2 (2022–2024) 5 97 37,000+