Suraksha Chakra (Circle of Protection)

“Challenges are what make life interesting and overcoming them is what makes life meaningful.” — Joshua J. Marine

Background:

Approximately 27 million children are born in India each year — the largest birth cohort in the world — but less than 44% receive a full schedule of vaccinations. The Govt of India appoints around 12 ANMs and ASHAs for a population of every 10,000 (only half of the WHO prescribed rate of 24.5) to facilitate all the pregnant woman and children under 5 years of age for receiving vaccinations under its UIP scheme and other programs like Polio etc.

India Lags behind almost by half in comparison to its GDP counter parts like Bangladesh where 82% of children are fully vaccinated by age two.

There are a number of reasons for this starting with the huge population of 1.27 billion people that need to be served by the government, that creates a barrier in itself. This is aided by one of the highest growth rates of 1.58%. To reach each and every one of such a huge cohort every year is obviously a daunting task. Geographical diversity (snow bound/ hilly areas, deserts, tropical forest areas, remote island territories), cultural diversity (with various religions, languages, traditions, beliefs and customs) and Political instability (“coalition” governments, “politically sensitive areas” like Naxal/terrorist-affected areas) are some problems that are rather unique to India and make the task more complex. Reaching out to mobile/migrant population (that is a significant proportion of population in some states) is another challenge.

Also, special efforts are needed to identify and reach some pockets of low immunization that are still there in many states. India had spent around $113 million on vaccine interventions in 2011, down from $137 million in 2009–10. There is need to step-up spending on vaccination front.

The following is a routine immunization chart prescribed by the government of India:

By age of 18 months, a child should be administered 6 individual vaccines. The first four vaccines itself are to be administered within the first 14 weeks. This is a lot to be remembered by a parent of a child being brought up in struggling conditions. Urban poor are estimated to be almost 50% of a city’s population. They are faced with issues of livelihood and impermanence of life. For a mother of such conditions, to remember to take her child to the doctor every 4 weeks is expecting a little too much. It is the ASHAs’ duty to go around taking rounds in the entire dwelling under her ward and remind the mothers to bring their child out for immunization. The mothers have to maintain an RI card which is expected to remind them / indicate to them when the next vaccine is due and which one it is. These RI cards have to be kept with care and maintained till the end of the vaccination cycle of the child. The failure of this system is another reason for the low rate of vaccinated infants in India.

This problem impacts the health of the entire nation. It is the government’s responsibility to ensure that all of its children grow up in a healthy and secure environment. India is a nation where 75% of its population is under 35 years of age. Being a young nation, it can leverage this advantage to many great possibilities that only a young nation can capture.

Therefore, we decide to take up this problem of remembering to inoculate a child of the urban poor strata, as our focus area.


Focus Area:

We realized that there is no in house system for them to remember that is it time for them to take their child for his/her next vaccination.

Appropriate vaccine administration is a critical component of a successful immunization program. The following are important guidelines to be kept in mind:

The right patient; 
The right vaccine or diluent; 
The right time*;
The right dosage; 
The right route, needle length, and technique; 
The right site; and, 
The right documentation.

  • (includes administering at the correct age, the appropriate interval, and before vaccine or diluent expires)

Therefore we designed our solution in such a manner that it independently reminds the family of each newborn child when it’s time for them to go for the next vaccination.

Cultural Context:

At the time of research, we were given a tour of their living quarters by a few participating families. In all said households we noticed that photos of Gods, ancestors and important display artefact were hung on the wall always along with a wall clock. This made us realise that a wall clock (almost always received as a gift on a important occasion) held a high importance in the household of the participants and was something that they always looked up to and admired, daily. This was complementary to the functional purpose of keeping the time. This identification was the origin of the concept of this project.


Solution:

Suraksha Chakra: Literally translating to a Circle of Protection, Suraksha Chakra is a modified wall clock that has an inbuilt time ticker and a low cost analog message display system. This clock, gifted to parents of a new born child, has a battery life of 2 years. Using the analog display and a pre-recorded voice alert, it reminds the parents of the time to next vaccination.

Please view an explanatory concept video here:

Concept video for Badlaav. This video was created using one of the early mock ups of the final product.

A working prototype was created using a clock module, very simple alarm, cheap speaker & led lights, all of which is available in the market at a very low cost. The outer casing was made with laser cut 2mm MDF. The count down to the next vaccination starts with a “3 weeks later” schedule, going down to “2 weeks later”, “1 week later” and reads upto “right away” for 1 whole week. The parent’s jobs is only to know when the next vaccination is due and take the child a health care provider on the due week. Based on the age of the child and previous record, the healthcare provider can determine which vaccine to administer.

With the text printed in the local language, a person can always look upto the clock and know how far out, the next vaccination is due. This call reads: “Get Vaccinated…3 weeks later…visit closets primary health care centre”

The electronic circuitry involved in the manufacturing of this clock is very simple. Similar to a basic alarm clock, this clock will be pre programmed to activate an alert only as per the child immunization schedule defined by the Govt of India.

Inside the wooden casing was a simple circuit made out of clock machinery, a countdown chip, speaker, led bulbs and a long lasting battery. All this could be controlled by a switch on the side to turn off the audio alarm once its purpose has been served.

For a detailed business plan and possibilities of taking the project further, please write to asmitamisra@gmail.com


Accolades: This project was designed to enter to the IIHS National Student Challenge, 2013. Our team of 2 students (Sahil Goyal & Asmita Misra) was selected amongst the top 25 finalists who got a chance to present their idea in the finals hosted at the Indian Institute of Human Settlements in Bangalore, India in Dec 2013.

A couple of national dailies covered the competition and featured our project

Role:

  • Research, Analysis, Problem Identification
  • Conceptualization and Product Design
  • Business Model Planning and Forecasting
  • Video Shooting and Editing