Karimnagar district collector Smita Sabharwal has been given the Gold Award for the best e-governance project (a health and nutrition initiative for expecting mothers) by the Andhra Pradesh government. The district has also won the Platinum Award for best overall implementation of e-governance projects.

Thirty-six-year-old Sabharwal, an IAS topper and badminton player who represented Karnataka, took over as the district collector in April 2011. Soon after, she introduced her health and nutrition scheme known as ‘Amma Lalana’— it has now been adopted by the state government and renamed as ‘Maarpu’. The purpose was to reduce high maternal and infant mortality rates in the district. A software, tailor-made to deal with the administrative shortcomings in fighting the problem, was launched.

The e-governance initiative for health and nutrition intervention is expected to bring the high maternal and infant mortality rates in the district drastically down in the next two to five years. The maternal and infant mortality is particularly high in many of the remote villages.

The software gives a direct pointer to areas prone to anaemia, high risk pregnancies, poor registration of antenatal and poor access to healthcare facility allowing the health department to focus on strengthening these core areas. Using technology the initiative connects the health department to expectant mothers and aid them in safe and hygienic deliveries. The system also alerts health officials if any of the women missed visiting a designated doctor or a primary health centre (PHC) for check-up.

In office or at home, Sabharwal logs on to a health and service delivery monitoring system several times a day to check the reds on a health map that is constantly updating — based on extensive field reporting. “It helps me identify the areas where expecting or lactating mothers need medical intervention because they suffer from low nutrition levels. This system receives inputs from health workers visiting pregnant women, fresh registrations of pregnant women, PHCs, self-help groups and gram sabhas,” Sabharwal says.

When she is not scrutinising health maps, Sabharwal logs on to Skype once every few minutes and connects to a randomly selected PHC. She also connects to PHCs in the remote areas and checks if the doctor has arrived at the PHC. Sometimes she asks a patient to be put online and makes enquiries.

“Now doctors cannot just lock PHCs and go away anymore. We have real-time monitoring of the PHCs using Skype, which is internet-based and free. Around 72 PHCs and eight government hospitals are online over Skype and at any given moment I can interact with the medical staff or patients or their relatives attending on them. It not only helps to check if basic facilities are being provided to them but also maintains discipline,” she says.

A few minutes later, she logs in to a welfare hostel or a girls school and asks the kids what food they had had and enquires about their general well-being. Of the 220 welfare hostels and girls schools, 100 are online at present. According to the state information technology and communication department, the Karimnagar model of using internet-based monitoring system is being adopted by Mahbubnagar, Srikakulam, Vizianagaram and Medak districts.

Apart from making these surprise online visits, Sabharwal keeps checking the dashboard of a one-of-its-kind performance monitoring system of government schools to know whether a student who is weak in mathematics is attending the special classes and whether there has been any improvement after the last class exam. “When I took over in April 2011, there were several government schools in the district which were in the red — pass percentage was so low that they were called ‘fail schools’ among locals. Teachers in government schools have a tendency to concentrate on good students while the weaker ones are usually neglected which often results in the latter dropping out. In this initiative, we have gathered the exam data of all the students in about 2,700 government schools in the district. One click and you will know the marks scored by a particular student of a particular school in every exam he/she wrote in the last two years,” she says. Sabharwal adds, “Using this micro tool, we identified students who were weak in some subjects like mathematics, and those who were weak overall. Those who fall in the B and C grade category have been ‘adopted’ and they have to attend special classes to improve their grades. Teachers and headmasters have been instructed where they need to focus and how students can improve.”

This initiative has resulted in 14 percent increase in pass percentage and around 18 percent students moving from lower to higher grades. About 72 of the 80 schools with less than 35 percent pass percentage have come out of the red zone. A total of 180 schools reported pass percentage improving from a range of 36-60 percent to above 60 percent. Of the 14,000 students who failed in their first exam, 6,000 passed in the second. Last year Karimnagar district topped SSC pass percentage in the state — with 93.38 percent students passing the exam.