Amakomaya: Register every new born child!

Amakomaya will secure the proof of identity of every child by tracking from birth via authenticated electronic data.

Citizenship identification in Nepal is the fundamental document which connects an individual to the state and secures the right to access the economic opportunities and social and political rights endorsed by the government. It is estimated that 5.4 million individuals aged 16 years and above in Nepal lack reliably verified or authenticated documents to prove their identities. According to the 2017 Health SDG profile of Nepal, only 58.1% of children under age 5 are reported and registered at birth. Parents face extreme difficulties in securing their children’s citizenship documents if births are not officially reported in the Ward office.

Lack of easy access to birth reporting channels in Nepal is a major challenge for birth registration. Parents travel many hours and sometime even more than a day to visit the ward office and submit official proof of the child birth document which includes child name, parents’ and grand parents details, date and place of birth etc.  In rural communities, low literacy compounds barriers to birth registration.  

Amakomaya (Mother’s Love) is an android application for Smartphone that tracks every registered pregnant woman and new born child, recording identification information such as parents’ name, date and place of birth, weight of child, and including details of the immunization record received by the child from the health facility.  

By using low cost android mobile/tablet devices, local health workers and female community health volunteer (FCHVs) can easily report the status of every pregnant mother and new born baby even  where dedicated internet connection is not present.  All electronic data of child and mother are verified and authenticated by the local health facilities during service delivery such as immunization and other services offered by the local government. The verified data are made available to the ward office to further authenticate the services administered by local government. Parents who need the birth certificate of their child can simply visit the ward office and place their QR-code or demographic information (such as name of child, registered phone number, parents name, location of birth etc) to obtain a copy. The aggregate data of registered individuals receiving maternal and newborn care are pushed to DHIS2 server managed by Ministry of Health and Population.

The parents have ownership and control of their child’s basic information and services received from government, as stored by Smartphone connected with the internet.

Since 2013, the Amakomaya program has been implemented in 35 communities, and 1 year ago it was adopted by several local government bodies. The application has been designed with a “human-centric” approach and has been modified to address all the lessons learned in the last 6 years. Initially the concept is to empower pregnant mothers by delivering lifesaving information for mothers and babies. During the course of implementation, the project has received lots of feedback from families of pregnant mothers, health workers, national level policy makers engaged in maternal and child health, and donor agencies.

The process of gathering data at birth to legally identify and provide unique digital identification token to each child is a simple, low cost and new process for solving the challenge. Strengthening existing maternal and newborn reporting systems with digital identification technology is a sustainable solution to solve the challenge.  Registered data of newborn child will be transferred to health facilities either on the day of birth or during the immunization session, will produce and authenticate the “legal identification” for each child.

The Amakomaya android application is a purpose-based application that provides lifesaving information to pregnant mothers and their families, as well as performance improvement solutions for health workers delivering quality maternal and newborn services. This application is useful for collecting limited personal information from pregnant mothers and their newborn children. The system has been designed to work even in areas with low internet connectivity.  Since this is an M-health application, the processed data is unique, accurate, error free and up-to-date, with high standards of confidentiality. Authorized health worker, as well as local government administrator has their own separate login credential to access recorded data.  All the data are stored inside the government data center (or Government Cloud) and conforms to lawful, fair and transparent processing.  All parents or guardians can access the child’s data by various credential methods such as QR-code, RFID chip set card, biometric finger print or user login credential. Once the child is old enough to receive citizenship identification, the parents or guardians will legally transfer the electronic data accessing credential to their child. 

In the existing system health workers are using QR-code to digitally identify the child. The proposed project is focused to replace QR-code by the digital identification system.

Female Community Health volunteers (FCHVs) visit door to door of each community to identify and register pregnant mother and newborn babies to assure access to health services and benefits offered by government. By using simple low-cost android device with the Amakomaya application, health workers collect basic demographic information such as date of birth, blood group, body health history, parents’ name and address which are important to verify and authenticate as key evidence to identify each single child.  Information are digitally stored and can be access by respective owner (parents or guardians) by using their encrypted unique IDs such as QR code, login user IDs password or biometric finger print authentication system.  Through the online system all collected data is officially accessed by the ward secretary, to validate birth registration and update to the central database installed by Department of National ID and civil registration. From this database ward office can issue digital identification for each child by using RFID based Smart Card or biometric authentication. 

Basically, the application is designed for pregnant women who have a low level of literacy. Also the application has been widely used by Female Community Heath Volunteers (FCHVs), who may be elderly and low literacy. The Ward office or ward secretary will access all the data through web-based interface. The web-based interface is also developed in the local language and includes all the indicators used and approved by Nepal’s government. From the perspective of development there are clear and user-friendly development guidelines for APIs developers as well as system integrators.

In June 2018 the Amakomaya application development team got an opportunity to participate and present in the conference on interoperable Digital Health for Universal Health Coverage. The technical team was trained on HL7 related standard for exchange, integration, sharing and retrieval of electronic health record from Amakomaya system to DHIS2 and HIMS server owned by Nepal Government. Now there are clear guidelines to develop APIs for the developer or vendor who like to connect communicate with Amakomaya system. At the moment all the collected data from Amakomaya app is available in DHIS2 Server.

The solution is designed to provide services in remote villages where internet connectivity is not existing. The application can be used with full features even in offline mode. Only modified and new inserted data are synchronized to server even in low internet connectivity. Initially the application was focused to deliver lifesaving content to the rural pregnant mother and FCHVs who have low level of literacy. So, the application is dominated with symbols, colors, numbers with less amount of text insert. 

In using this unique digital IDs approach, it is the vision of this program that no mother and child will fail to receive the quality health services and other benefits provided by government. The instant availability of unique digital IDs of each child to local government greatly reduces the difficulties of assuring legal identification of each child. This system will directly strength the National ID and Civil Registration Department of Federal Government by providing multilevel authenticated and verified unique identification of from grassroots.

Amakomaya is working with Government and not-for-profit organizations. The company has been developing various innovative technology and solutions that is useful to improve economic livelihood of community. As a service receiver government and non-for-profit organizations outsource the developed technology, services and solutions from Amakomaya. To sustainably continue and running the further process of development of technology and services company charge reasonable cost with government and other non-profit organizations. 

The team has capacity of development of innovative technology and application as per local needs that have economic value. The team can develop mobile applications, Internet of Things (IoTs) solutions that can be used by local communities in the language they speak. Additionally, the team are working with huge data management project based on Big Data technology. Another strength of the team is to manage project even in hard to reach area of the country. Connecting remote villages by broadband wireless technology, deploying tele-medicines, tele-educations and various tele-services those have social value for the communities.  

The revenue model of this company is to sale services and technology to government as well citizens. Since last 6 years the company have introduced various types of innovative applications and services those have social and economic value thus sponsored by government as well as donor agencies. For example, “Amakomaya” , “Amakomaya Care” , “Vial-to-child”  are 3 different Android apps having different purpose but are linked to each other and providing integrated services to the citizens as well as government. These apps have been widely accepted by local government bodies as well as UN agencies such as UNICEF and WHO in Nepal. The integration of proposed unique digital IDs solution for new born child will create additional economic value for this application. The person who needs instant birth certificate without visiting to ward office can just pay small amount of service fee to the system and can get electronic copy of birth certificate from the mobile application.

The reason of applying to the Mission Billion Challenge is to improve the quality life services of citizens by using electronics data recording and management technology. The technology will generate unique digital identification for each newborn child and assure all the services and benefits are transparently received by its owner. The participation of Amakomaya project with Mission Billion Challenge will advance the project toward improving the National ID and Vital registration system of country. This solution will completely reduce the difficulties that have been faced by all citizens as well as government agencies too.

At the moment the key barriers for our solution to succeed is a delay on deploying services and facilities in local government bodies. To overcome this delay, following strategies should be adopted. 

•  Advocacy on the importance of unique digital IDs for citizens to National policy makers, bureaucrat, and political leaders. 

•   Develop and introduce additional economics value adding features in the Unique digital IDs for the citizens. 

•  Create wide range of funding partnership to continually extend this project in all part of the country.