Project Name: eCompliance
Organisation: Operation ASHA
Project Location & Coverage Area: Delhi, Chhattisgarh, Madhya Pradesh, Orissa, Punjab, Rajasthan, Uttar Pradesh
Project URL: www.opasha.org
Area of intervention: Health

Founded in 2006, Operation ASHA (OpASHA) provides tuberculosis treatment and education services in 2,053 slums and villages in nine Indian states and two provinces in Cambodia. As part of its larger project of identification and treatment of TB patients, OpASHA launched in 2013 is a mobile application eCompliance system which tracks every dose taken by every patient.
This is a necessity because of the tedious and difficult regimen prescribed under the DOTS therapy in which a TB patient must take up to 75 doses under observation. This is the therapy prescribed by WHO and followed across the world. eCompliance software is loaded on a seven inch tablet, which has a SIM card. This connects the tablet to a server through internet or text messages. The tablet updates the server every 20 minutes.
eCompliance tracks every activity required to deliver high quality TB treatment. It advises the health worker to carry out pre treatment counselling. Simultaneously, the patient is also registered with her fingerprints in the eCompliance system. Then the first dose is dispensed. Thereafter, every time the patient has to take the medication, both the counsellor and the patient have to give their fingerprints simultaneously. This generates irrevocable evidence that the meeting took place, every time, and the medicine was taken under observation.

If a dose is missed, eCompliance issues an alert to the patient, health worker and his supervisor. The health worker has to meet the patient within 24-48 hours to provide further counselling and deliver the dose, ensuring that the patient re-joins the therapy. This meeting is also evidenced with a fingerprint. Thus, no fudging or manipulation can take place. This helps to achieve a very high adherence and treatment success rate.

Reach & Road Ahead

The eCompliance pilot project of OpASHA was launched in 17 different TB centers with 26 terminals in South Delhi slums and villages. Over 1,400 patients used biometric identification to verify over 60,000 visits and follow-ups. Over the period of a year, the default rate was reduced to nearly 1 per cent, much lower than the Revised National TB Programme’s (RNTCP) 6-7 per cent. Presently, eCompliance has been rolled out for nearly 9000 TB patients so far in India, Cambodia, Uganda, Dominican Republic and Kenya. It has already recorded over 400,000 transactions. Nearly 185 eCompliance units are now functional. The total cost of each eCompliance terminal is less than INR 20,000 and the cost per patient is INR 120.