Harnessing mHealth to improve the diabetes screening and diagnosis rate in rural Indian settings: a learning from health systems initiative

Akash Gajanan Prabhune, Aparna Manoharan, Murugan Arul


Background: Diabetes forms huge burden of non-communicable diseases that is affecting health care systems in India. India has large number undiagnosed and undetected cases. mHealth initiatives are cost effective, quick and less resource intensive technology assisted initiatives which help to strengthen the health system. High mobile penetration and availability of cheap and high-speed data network across India has been conducive to implement mHealth initiatives in Indian health system. We present our experience in using mHealth initiative to improve the diabetes screening and diagnosis in rural Indian settings.

Methods: The study is a descriptive analysis of all the tasks undertaken as part of “Disease free Village” Initiative of our organization. The study data is operational data from our organizational health information management systems. The study is divided into three phase. Phase 1, was dedicated to enrolling entire village population using android smartphone and ODK collect application; phase 2 used clinical decision support system for screening of high risk individuals and phase 3 used traditional door to door campaign to motivating the high risk individuals to get their fast and post prandial blood glucose levels checked at health care facility.

Results: Phase 1 was to set a baseline, with 3624 base population, 2651 was target adult population. Rapid screening in phase 2, screened 2204 (83.14%). Out of 2204 screened cases 1307 were high risk cases. 1307 high risk cases were followed in Phase 3, and blood glucose screening was carried out 1156 (88.44%) high and moderate risk individuals out of 1307 (100%).

Conclusions: We concluded that the mHealth initiatives for screening and diagnosis of diabetes in rural India, combined with traditional techniques could help to improve screening and diagnosis rate and help to reduce the hidden burden of disease.


mHealth, Diabetes screening and diagnosis, Clinical decision and support system, Rural health

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Samb B, Desai N, Nishtar S, Mendis S, Bekedam H, Wright A, et al. Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. Lancet. 2010;376(9754):1785–97.

RDS_HealthRiskFactors_India_WEB.pdf. Available at: documents/RDS_HealthRiskFactors_India_WEB.pdf. Accessed on 11 September 2017.

Services DGOH, Ministry of Health and Family Welfare, Government of India. National programme for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS) [cited 2017 Sep 11]. Available from: Accessed on 11 September 2017.

Planning Commission Government of India. Report of the working group on disease burden for 12thFive Year Plan: WG-3(2) non communicable diseases. c2011. Available at: http://planningcommission. Accessed on 11 September 2017.

World Health Organization, WHO Global Observatory for eHealth. mHealth: new horizons for health through mobile technologies. Geneva, Switzerland: World Health Organization; 2011.

Bhattacharya S, Kumar A, Kaushal V, Singh A. Applications of m-Health and e-Health in Public Health Sector: The Challenges and Opportunities. Int J Med Public Health. 2018;8(2):56–7.

Labrique AB, Vasudevan L, Kochi E, Fabricant R, Mehl G. mHealth innovations as health system strengthening tools: 12 common applications and a visual framework. Glob Health Sci Pract. 2013;1(2):160–71.

Logaraj M, Balaji R, Rushender R. A study on effective utilization of health care services provided by primary health centre and sub-centres in rural Tamilnadu, India. Int J Community Med Public Health. 2016;1054–60.

Prabhune A, Manoharan A. Assessment of Healthcare Utilization in a Community-Centric Model of Primary Healthcare for Rural Populations. Indian J Public Health Res Dev. 2017;8(4):971.

Bassi A, John O, Praveen D, Maulik PK, Panda R, Jha V. Current Status and Future Directions of mHealth Interventions for Health System Strengthening in India: Systematic Review. JMIR MHealth UHealth. 2018;6(10):e11440.

Ajay VS, Jindal D, Roy A, Venugopal V, Sharma R, Pawar A, et al. Development of a Smartphone-Enabled Hypertension and Diabetes Mellitus Management Package to Facilitate Evidence-Based Care Delivery in Primary Healthcare Facilities in India: The mPower Heart Project. J Am Heart Assoc. 2016;21:5(12).

Jindal D, Gupta P, Jha D, Ajay VS, Goenka S, Jacob P, et al. Development of mWellcare: an mHealth intervention for integrated management of hypertension and diabetes in low-resource settings. Glob Health Action. 2018;11(1):1517930.

Kumar S, Shewade HD, Vasudevan K, Durairaju K, Santhi VS, Sunderamurthy B, et al. Effect of mobile reminders on screening yield during opportunistic screening for type 2 diabetes mellitus in a primary health care setting: A randomized trial. Prev Med Rep. 2015;2:640–4.

Patnaik L, Joshi A, Sahu T. Mobile phone-based education and counseling to reduce stress among patients with diabetes mellitus attending a tertiary care hospital of India. Int J Prev Med. 2015;6:37.

Ramachandran A, Snehalatha C, Ram J, Selvam S, Simon M, Nanditha A, et al. Effectiveness of mobile phone messaging in prevention of type 2 diabetes by lifestyle modification in men in India: a prospective, parallel-group, randomised controlled trial. Lancet Diabetes Endocrinol. 2013;1(3):191–8.

Kumar D, Raina S, Sharma S, Raina S, Bhardwaj A. Effectiveness of randomized control trial of mobile phone messages on control of fasting blood glucose in patients with type-2 diabetes mellitus in a Northern State of India. Indian J Public Health. 2018;62(3):224.