A Study on voice based data collection using mobile phones in rural health care system

Suma Prashant1, Vasumathi. A1, Prof. Ashok Jhunjhunwala2 , Umesh Sachdev3

1

IITMs Rural Technology and Business Incubator, Chennai IIT Madras, Dept. of Electrical Engineering, Chennai Uniphore Software Systems Limited, Chennai

Abstract: The schemes and programs implemented by the Government of India generate enormous amount of data. However it is challenging to retrieve, monitor or analyze the data gathered in continuum. A voice based system has been developed to support voice biometrici and voice based data entry. The innovative use of Modern Voice recognition technologies indicates effective data storage and immediate access of the same. This system can play a pivotal role in enabling real-time data collection from remote areas. This voice based data entry system was tested by National Research Developmental Corporation in Dhar District of Madhya Pradesh to capture and monitor Maternal and Child Health data on a real-time basis. In this paper we share findings on using voice based data collection using mobile phones in rural health care systems in remote areas of Madhya Pradesh, India. Background Malnutrition in India has reached epidemic proportions, and it is estimated to be higher than sub-Saharan African countries 1 . According to the NFHS-III, 60 percent of the children in the 0-3 years category in Madhya Pradesh are malnourished, with 82.6 percent children in the same age group being anemic 2 . Government of India has employed several health schemes to combat malnutrition and improve Maternal and Child health. However the success of these schemes and programs are hindered due to enormous amount of data generated and distortion in government records. Current

system of data collection using paper-based process has its challenges; 1. Unmanageable amounts of paper data, 2. Too much time consumed in generation and aggregation of reports, 3. Inefficiency in flow of information , 4. Tampering of Data. Fudging of

http://www.thehindu.com/2009/11/28/stories/2009112858112000.htm

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government health records3 is one of major concerns suggestive of data discrepancy in the health sector of India. Can Information Communication and Technologies be used for data authentication, minimize data inconsistency, avoid data flooding and improve overall improve transparency in data collection process? Technology solution A voice based data entry system jointly developed by IITMs Rural Technology and Business Incubator and Uniphore Software Systems can support voice biometric and enable voice based data entry. When this system is substituted for the current paper based data collection processes, it played a pivotal role in enabling real-time data collection from remote areas thereby reducing discrepancy in data which is most commonly observed in the data collection phase. This step would facilitate greater lucidity in implementation of Government Schemes in rural Madhya Pradesh where malnutrition has reached epidemic heights and Anganwadi centers (rural healthcare outreach centers) are remotely located.

Pilot location This voice based system was introduced Anganwadi centers in two districts namely Gunawat and Dhar of Madhya Pradesh to register and monitor the beneficiaries (here rural and tribal mother and children) of the Integrated Child Development Scheme, of Govt. of India. As discussed earlier in the introduction of this paper, malnutrition in Madhya Pradesh has reached epidemic proportion and the Integrated Child Development Scheme is one of the schemes implemented by government to combat malnutrition among women and children in urban, rural and tribal areas.

2 3

http://beta.thehindu.com/news/states/article109702.ece http://www.indianexpress.com/news/med-officers-wings-clipped-for-fudging-data/383706/

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Figure 1 -Pilot Location in MP The Methodology -Voice based data collection The beneficiaries had to enroll/register themselves with the system using their voice and later authenticate themselves every time they visit the Anganwadi centre and enter data about their activities at the Health Center and the benefits they have received. Speech recognition, inputs and verification foster voiceprint and ID match for unique data entry. The innovative use of Modern Voice recognition technologies indicates effective data storage and immediate access of the same. The data that has been captured using the voice based data entry system can be viewed on a real time basis from a web portal. Data collected would include details such as, 1. Registration of mother/child/guardian and supervisor 2. Voice Authentication 3. Data Collection:a. Weight- mother/child b. Number of nutrition packets received - mother / child c. Counseling received by mother and infant mortality
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d. Infant Mortality

1. Registration:Registration process is for four categories of individuals Mother, Children, Guardian and Supervisors. The mother can register herself and her child, as children are not allowed to register because their voice tends to change as they grow older but they are generated a unique ID with prefix of mothers ID. The system generates a unique user ID which is a three digit number for each registered individual. About 589 mothers, 702 children, 9 Guardian and 3 supervisors have registered themselves between the months February 2010 to June 2010.

2. Voice Authentication/Attendance:The registered users had to authenticate themselves each time they wanted to enter data into the system by a simple three step process, Making a phone call to the systems mobile number Confirming the unique three digit User id generated when registering Voice authentication: Repeating the pass phrase4 thrice Some participants failed to remember their individual pass phrase and made few mistakes which made the system reject the authorization. E.g. If a participant registered using a pass phrase My name is Mala and later forgot the pass phrase and said Mala is my name the authentication would fail as the system would not identify the user. Other

reasons for failure of authentication include loud background noise, telling the wrong pass phrase, change in voice pattern, external noise, change of instrument, bad network coverage, to problems in the voice biometric algorithm.

3. Data Collection:-

A pass phrase is like a voice pin, it is a sentence chosen by the user which he/she registers and later repeats in order to get authenticated.

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Once the voice authentication is over the user can navigate various option given in the system using voice prompts and enter the data that needs to be entered. Once the user enters the data they can either exit the system and end the call or return to the system and enter more data under other options given. This entire process was entirely carried out through a simple call from a mobile or fixed line. Most of the participants were illiterate and were from rural backgrounds, but quickly adapted to the procedure. The supervisors would be present during data entry but it was the participants who entered the data. Initially the data that was collected from the field would be saved in the system data base and then transferred to readable excel sheets.

Figure.1. Voice based data entry

This process was upgraded such that data that was captured on the field would be uploaded on a web portal, where the administrators could view real-time data.

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Figure.2. ICDS web portal showing digitized data of voice based data

This web portal had district wise, Block wise, Anganwadi centre wise information about mother and children registration, weight, number of Supplementary Nutrition Packets received under government scheme, it also had addition information about immunization schedules, growth charts of children and nutrition and health education and preschool education. Later phase of data collection saw incorporation of more options such as Antenatal Checkup date of expectant mother, Number of Iron and folic acid tablet received my mother, date of receiving Tetanus Toxoid injection.

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Conclusion There are several advantages of using mobile based voice data entry system, it enables complete transparency and eliminates middlemen in data collection, there is no chance of tampering with the collected data, the data can be compiled easily, the entire process can be carried on mobile phone through the process of a simple telephone. The process also facilitates real time reporting, the data captured via mobile is streamed live on the web portal. The entire process of data entry and well as the authentication is simple and can be completed in less than 2 minutes. The entire process is carried out via mobile phone with no internet dependency and hence it enables data collection from remote areas which do not have internet penetration. The voice system can be hosted in any language or dialect. We have outlined preliminary finding about using voice based data entry through mobile phone in Madhya Pradesh, under the ICDS scheme.

Acknowledgement This work was carried out under the IU-ATC project funded by the Department of Science and Technology (DST), Government of India and the UK EPSRC Digital Economy Program.

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