Leveraging Tech Tools to Promote Health

  • During her Fulbright-Nehru project, Lilianna Bagnoli assessed the understanding of a paper-based tool used by Anganwadi workers during their nutrition service delivery activities. Photograph courtesy Lilianna Bagnoli
  • The paper-based tool, called a child growth monitoring chart, is used to compare an individual child’s growth to an international growth standard for children of the same age. In India, Anganwadi workers maintain these charts for each child until they reach 5 years of age. Photograph courtesy Lilianna Bagnoli


 U.S. Fulbright-Nehru student researcher Lilianna Bagnoli worked on data visualization and reporting to assist workers in rural childcare centers in India.

The future of the social sector lies in part within the adoption of data-driven decision-making. This is a process that can help optimize resource allocation. U.S. Fulbright-Nehru student researcher Lilianna Bagnoli, who studied the extent to which technology can assist workers in rural childcare centers in India with the analysis of growth monitoring data, is a great example of how data-driven decision-making can have a positive impact.


Bagnoli’s project in 2018-19 culminated in a set of solutions that can be implemented by the government to enable stakeholders to leverage data for development. Bagnoli is currently working at Dimagi, a Massachusetts-based for-profit social enterprise with offices in New Delhi and South Africa, that delivers open-source software technology suitable for low-resource settings and underserved communities. In particular, she is working on the implementation of the national-scale Integrated Child Development Services project in India.


Bagnoli explains that much of her current work has grown from the opportunities provided by her Fulbright-Nehru fellowship at Dimagi in New Delhi. “I completed my Fulbright research grant from February 2018 to February 2019, where my home institution (in the United States) was my alma mater Grinnell College, and my host institution (in India) was Dimagi,” she says. “My research project was inspired by my prior experiences working with organizations in India that tackled social impact issues with data and technology.” In particular, Bagnoli focused on data visualization and its impact on the social sector. “As a member of the data team, I collaborated with partners to understand reporting and data visualization requirements for social impact initiatives across sectors,” she says. Bagnoli’s association with Dimagi continued after she completed her Fulbright research as she returned to the organization in 2019 as a project manager.


Dimagi runs some of the largest mobile health projects in the world and Bagnoli was a key participant in its work in India. “I worked on Dimagi’s project with the Government of India, where we created and deployed a mobile app used nationally by 600,000+ healthcare workers, called Anganwadi workers,” says Bagnoli. “They used our app to register and track the nutritional status of mothers and infants. In turn, data collected through the mobile application was used to track key nutritional indicators related to malnutrition in both children and mothers/expectant mothers. Dimagi runs similar projects globally.”


Through her work as a Fulbright-Nehru student researcher, Bagnoli deepened her commitment to discovering ways to utilize technology to positively impact social change. “Dimagi leverages technology to provide tools and data to frontline workforces and programs around the world,” she says. “The goal of this work is to improve the quality and efficiency of services delivered by frontline workforces, primarily in the healthcare sector.”


Anganwadi workers face a number of challenges, including knowledge gaps that may be due to a lack of or insufficient training, and a need for technical or analytical skills. Bagnoli’s research aimed to understand “how technology tools may be able to intervene and address knowledge gaps, with the goal of equipping frontline workers and their patients with important health information.” As part of this work, Bagnoli interacted with 80 Anganwadi workers in Jharkhand. “For my project, I assessed the understanding of a particular paper-based tool called a child growth monitoring chart that is used by Anganwadi workers during their nutrition service delivery activities,” she says. “At a high level, growth charts are used to compare an individual child’s growth to an international growth standard for children of the same age. In India, Anganwadi workers maintain these charts for each child until they reach 5 years of age. In an ideal scenario, the growth charts alert an Anganwadi worker if a child’s growth trajectory stagnates or decreases, triggering a number of nutrition-related interventions including counseling of the child’s caretaker and, in extreme cases, referral to a Nutrition Rehabilitation Centre.”


Bagnoli says that in addition to illuminating the incredible work of community health workers, her Fulbright-Nehru research has solidified her belief in the following aspects of her work going forward: “Technology is an important tool for amplifying the impact of frontline workforces and public service delivery programs; the importance of a user-centered approach to technology design and implementation; and the value of designing field research and user-testing activities that allow community health workers to describe their work in context.”


Trevor Laurence Jockims teaches writing, literature and contemporary culture at New York University.