Poster Topical Area: Nutrition Education and Behavioral Sciences

Location: Auditorium

Poster Board Number: 167

E12-05 - “It’s not just a phone”: Facilitators and barriers to integrating an information & communications technology (ICT) application in India’s flagship nutrition program

Sunday, Jun 10
8:00 AM – 6:00 PM

Objectives: A mobile-phone based ICT application, intended to digitize beneficiary enrollment, enable beneficiary tracking, and support delivery of ICDS services, is being integrated into the Integrated Child Development Services (ICDS) program in India. In the context of an ongoing impact evaluation of the ICT tool, we examined frontline worker (FLW) perceptions of the tool and stakeholder insights on factors that affected roll-out and scale up.

Methods: We used a telephonic survey with FLW (N=204) in intervention areas to assess ICT tool usage, challenges and FLW satisfaction. Data were tabulated. We conducted in-depth interviews with core stakeholders involved in early support to implementation of the ICT tool (N=13). We analyzed interviews using a theoretical framework of program scale-up to identify salient facilitators and barriers to roll-out and implementation of the ICT tool.

Results: Early integration of the ICT tool appeared successful. The majority of FLWs used the ICT tool daily (82%), 81% found it ‘easy’ to use and 74 % preferred it over their paper-based records. When asked about challenges, most FLWs reported network (90%) and phone hardware problems (60%).

Stakeholders identified several factors that facilitated rapid integration of the ICT tool into the ICDS: the leadership of a senior government official, multiple external partners working together to support roll-out, availability of external funding, and links to a broader political vision of technology integration in India. Major roll-out challenges identified included delays in hardware procurement and dashboard development, limited server capabilities, and network shutdowns. Stakeholder perceptions about challenges to further scale-up included limited mechanisms for transfer of software and implementation support from external partners to the government, lack of plans for hardware replacement and training support, differential uptake by state governments and presence of other health ICT tools.

Conclusions: Early findings suggest positive FLW experiences with uptake and use of an ICT tool in the ICDS in India. Further scale-up requires investments in strengthening network infrastructure and institutional mechanisms to support implementation needs, and alignment with other ICT tools.

Funding Source: Bill & Melinda Gates Foundation, via grants to IFPRI and UCSF

CoAuthors: Sneha Mani – International Food Policy Research Institute; Phuong Nguyen – International Food Policy Research Institute; Nitya George – International Food Policy Research Institute; Lakshmi Gopalakrishnan – NEERMAN; Sumeet Patil – NEERMAN; Nadia Diamond-Smith – University of California, San Francisco; Lia Fernald – University of California, Berkeley; Dilys Walker – University of California, San Francisco; Purnima Menon – International Food Policy Research Institute

Rasmi Avula

Research Fellow
International Food Policy Research Institute
New Delhi, Delhi, India