Business Requirements Document (BRD)
Sakhi 2.0
Version 2.4.0

Date	Version Number	Author	Approved By	Document change reference
02 Jun 2025	2.4.0	Madhava Ramu		Existing BRD with details of all comprehensive ASHA modules
04 Jun 2025		Madhava Ramu		Revised draft with changes in HBNC, Eligible couple Tracking module

Document Revision History

Contents
1 Introduction
1.1 Document Purpose
1.2 About Piramal Swasthya
1.3 Background
1.2.1 Background of ASHA Concept
1.4 Roles & Responsibilities of ASHA
1.5 ASHA is expected to fulfill her role through below 5 major activities in the community
2 About the ASHA application
2.1 Purpose
2.2 Scope of Work
2.3 Users of the system
2.4 In Scope ASHA Functional Modules
2.5 App Functionality
2.5.1 Household and beneficiary Registration Functionality
2.5.2 Lists sections and type of Lists and condition
2.5.3 Process of Generating Beneficiary Ids
3 Door-to-door Survey
3.1 System Validations
3.2 New Household Registration
3.2.1 Family Details
3.2.2 House Hold Details
3.2.3 House Hold Amenities
3.3 Family member Registration
3.3.1 Beneficiary Registration
3.3.2 OTP Consent Mechanism
3.3.3 Status of Woman
3.4 Eligible Couple Module
3.4.1 Eligible couple Registration
3.4.2 Eligible couple Tracking
3.5 Maternal Health
3.5.1 Pregnant Women Registration
3.5.2 Ante Natal care visits
3.5.3 PMSMA Form
3.5.4 Delivery Outcome
3.5.5 Post-Natal Care Visits of Mother
3.5.6 Micro Birth Plan
3.6 Child Care
3.6.1 Infant Registration
3.6.2 Child Registration
3.6.3 HBNC: Home Based Newborn Care
3.6.4 HBYC: Home Based Care for Young Child
3.7 Immunization
3.7.1 Immunization schedule as per above Age groups
3.7.2 Immunization data entry screen
3.7.3 Immunization schedule Date logic
3.7.4 Immunization schedule for Pregnant Woman
3.8 Death Reports
3.8.1 Child Death Review
3.8.2 Maternal Death Surveillance and Response
4 Disease Control
4.1 Non-Communicable Diseases
4.1.1 Community Based Assessment Checklist (CBAC) Form
4.2 Communicable Diseases
4.2.1 Tuberculosis
4.2.2 TB Screening
4.2.3 Suspected TB cases
5 Dashboard
5.1 ASHA Dashboard
5.2 ASHA Work Plan
5.3 SAKHI App Modules and flow diagram

Definitions, Acronyms, and Abbreviations

S. No	Term / Acronym / Abbreviation	Full form/ Definition
1	FLW	Frontline Health Workers; i.e. ASHA, ANM and AWW
2	ASHA	Accredited Social Health Activist
3	ANM	Auxiliary Nurse Mid-Wife
4	AWW	Anganwadi Worker
5	MO/ MOIC	Medical Officer/ MOIC – Medical Officer In charge
6	RCH	Reproductive and Child Health
7	VHND/ VHSND	Village Health Nutrition Day / Village Health Sanitation and Nutrition Day
8	NDD	National Deworming Day
9	M/O	Mandatory/Optional
10	EC	Eligible couple
11	PW	Pregnant Woman
12	HRP	High Risk Pregnancy
13	ANC	Antenatal Care: A pregnant Woman has 3 stages first trimester, second trimester and third trimester.
14	PNC	Postnatal Care: Post Delivery period for Mother and Infant up 42 Days.
15	LMP	Last Menstrual Period
16	EDD	Expected Date of Delivery
17	DOB	Date of Birth
18	LBW	Low Birth Weight Baby
19	RMNCH+A	Reproductive, Maternal, Newborn, Child and Adolescent Health
20	RMNCAH+N	Reproductive, Maternal, Newborn, Child, Adolescent Health Plus Nutrition
21	HBNC	Home Based Newborn Care
22	HBYC	Home-Based Care for Young Child
23	SNCU	Special Newborn Care Units
24	NCD	Non-Communicable Diseases
25	CBAC	Community Based Assessment Checklist
26	CDR	Child Death Review
27	MDSR	Maternal Death Surveillance and Response
28	MCTS	Mother and Child Tracking System
29	NHM	National Health Mission
30	NRHM	National Rural Health Mission
31	NUHM	National Urban Health Mission
32	NIC	National Informatics Centre
	CDC	Centers for Disease Control and Prevention
	NCVBDC	The National Center for Vector Borne Diseases Control
	NVBDCP	National Anti-Malaria Program (NAMP) renamed as National Vector Borne Disease Control Program

Introduction

Document Purpose

The purpose of this document is to capture and describe business and application requirements of "Sakhi Android mobile application for ASHAs". Which is being designed for android smart phones and tablets. This document will help the organization to collect and analyze all the various ideas that have come up to define the system, its requirements with respect to its intended users. It also describes functional and nonfunctional requirements, design constraints and other factors necessary to provide a complete and comprehensive description of the application's scope and requirements. Also, we should predict and sort out how we hope this product will be used in order to gain a better understanding of the System.
The Scope of the document is confined to capturing the requirements of the application and its interaction with other related applications.
NOTE: This version of BRD / SRS is subject to changes depending on the feedback provided during the course of document evaluations by various stakeholders. A final version of BRD will be shared once there is an official sign-off by the stakeholders on agreeing to freeze the requirements.

About Piramal Swasthya

Piramal Swasthya Management and Research Institute (PSMRI), an initiative under the aegis of Piramal Foundation. Is one of the largest not-for-profit organizations in India. Piramal Swasthya is contributing with its experience and expertise of building innovative solutions that impact at scale.
Piramal Swasthya is focused on bridging the public healthcare gaps by supplementing and complementing the Government of India's vision to meet Universal Health Coverage. In the primary public healthcare space with a focus on Maternal, Child and Adolescent Health and Non-communicable Diseases. Piramal Swasthya has more than a decade-long experience in operating several healthcare innovations at scale, which are addressing the primary healthcare needs of the most underserved and marginalized populations across India. Piramal Swasthya is operational in 21 States in India through 35 innovative public healthcare delivery programs and has served more than 112 million beneficiaries so far.
One such innovation is AMRIT (Accessible Medical Records via Integrated Technologies) which is a digital health platform developed by Piramal Swasthya that stores electronic health records of beneficiaries for the use of public primary healthcare service delivery and decision-making. The platform enables the connection between beneficiaries, health facilities, and frontline workers in an integrated ecosystem through technology.
Services and features under AMRIT Platform:
HWC Application: A comprehensive application with 12 Service packages.
MMU Application: Offline and Online Application to support operations in outreach programs.
HIHL Application: Helpline CRM to support services like 104, 1097, MCTS and ECD with inbound and outbound facility.
Telemedicine Solution: Video consulting facility.
Smart Phone Applications: Sakhi/ Utprerona Android Mobile App ASHAs.
Point of Care Device: AMRIT is integrated with PoCT devices like Fetosense and Healthcube etc.
ABDM compliant: and AMRIT is integrated with ABDM for ABHA with all three (M1, M2, M3) milestones.

Background

Background of ASHA Concept

The Government of India launched National Rural Health Mission (NRHM) in 2005 to address the health needs of rural population, especially the vulnerable sections of society. The Sub Centre (SC) is the most peripheral level of contact with the community under the public health infrastructure. This caters to a population norm of 5000, but is effectively serving much larger population at the SC level.
Thus, provision for a new band of community based functionaries, named as Accredited Social Health Activist (ASHA) was made to fill this void. ASHA is the first port of call for any health related demands of the rural population, especially women and children, who find it difficult to access health services.
ASHA is volunteer health activists in the communities, who is creating awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing public health services. She is a promoter of good health practices.
ASHA will be entitled for Performance Based Incentives fixed by the NRHM State HQ for prefixed activities only. The performance based incentives required to be given on monthly basis to ASHA.
The role, responsibilities, profile and compensation package for ASHA is given below.

Roles & Responsibilities of ASHA

The roles and responsibilities of an ASHA include the functions of a healthcare facilitator, a service provider and a health activist. Broadly, her functions involve providing preventive, promotive and basic curative care in a role complementary to other health functionaries; educating and mobilizing communities particularly those belonging to marginalized communities, for adopting behavior related to better health and create awareness on social determinants, enhancing better utilization of health services; participation in health campaigns and enabling people to claim health entitlements. She is also providing a minimum package of curative care as appropriate and feasible for that level and making timely referrals for further treatment.
Her roles and responsibilities are as follows:

ASHA have to take steps to create awareness and provide information to the community on determinants of health such as proper diet and nutrition, basic sanitation and hygienic practices, healthy living and working conditions, information on existing health services and the need for timely utilization of health and family welfare services at doorsteps.
ASHA have to conduct home visits of the pregnant women/mother/newborn under Home Based Post Natal Care (HBPNC), and they are supposed to counsel pregnant women on birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infection (RTIs/STIs) and care of the young child.
ASHA have to mobilize the community and facilitate them in accessing health and health related services available at the village/sub-center and other public health facilities, such as Routine Immunization (RI), Ante Natal Check-ups (ANCs), Post Natal Check-ups (PNCs), sanitation and other services being provided by the Government.
ASHA have to work with the Village Health Sanitation Nutrition Committee/Village Level Committee (VHSNC/VLC) of the Gram Panchayat to facilitate a comprehensive village health plan with ANM, AWWs and PRI members.
ASHA have to mobilize targeted community once in a month for the celebration of Village Health Nutrition Days (VHND) at their Aanganwadi Centre. The ANM, AWW, Members of VHSNC and community people are expected to participate in the celebration of VHND.
ASHA have to arrange escort/accompany pregnant women & children requiring treatment/ admission to the nearest pre- identified health facility i.e. Primary Health Centre/Community Health Centre/ First Referral Unit (PHC/CHC /FRU).
ASHA have to provide primary medical care for minor ailments such as diarrhoea, fevers, and first aid for minor injuries. ASHA are also acting as Dot Providers of Directly Observed Treatment Short-course (DOTS) under Revised National Tuberculosis Control Program (RNTCP).
ASHA are also acting as a Depot Holder for essential provisions being made available to every habitation like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet (IFA), chloroquine, Disposable Delivery Kits (DDK), Contraceptives (Condoms, Oral Pills, Emergency Pills), etc. Provision of Drug Kit and HBPNC Kit has been made for ASHA. Contents of the Drug/HBPNC Kits are based on the recommendations of the expert/technical advisory group set up by the Govt of India.
ASHAs' role as a service provider is being enhanced subsequently. The state makes provision of graded training to ASHA for providing newborn care and management of a range of common ailments particularly childhood illnesses.
ASHA are expected to provide first information about the births and deaths in her village and any unusual health problems/disease outbreaks in the community to the SC/PHC/CHC or directly to the District Authorities or even to the State HQ at the NRHM Help Line.
Fulfillment of all these roles by ASHA are envisaged through continuous training and up- gradation of their skills over the years.

ASHA is expected to fulfill her role through below 5 major activities in the community

Home Visits
Attending Village Health and Nutrition Day (VHND)
Visits to the health facility
Holding village level meeting
Maintain records

About the ASHA application

ASHAs usually use multiple registers for beneficiary registration, enumeration, data collection. This leads to challenges of manual errors, loss of data and data accuracy.
In this context Piramal Swasthya has developed a Mobile application for ASHA workers to digitalize and reduce the manual work.
Sakhi/Utprerona is an Android mobile application specially designed for healthcare programs and consultation services render by ASHAs' to serve pregnant women, mothers and newborns in India. This ultimately eliminates pen and paperwork by ASHAs and carries out entering beneficiaries' data in a digitalized process with increased ease and accuracy of data. It is named Sakhi in Bihar State and Utprerona in Assam State.

Purpose

The Sakhi/Utprerona application is designed to enable ASHAs to capture household beneficiary-level data, including data on noncommunicable diseases (NCD), maternal and child health, family planning, and immunization, amongst others. The purpose of the application is to digitally empower ASHAs to reduce duplication and manual labor and in turn, increase their efficiency. The application aims to create a continuum of care for the beneficiaries by creating a longitudinal form of Electronic Health Records (EHR) and ensure timely and accurate data collection from the ground that can be used for decision-making not only by the ASHA but also by health officials at the block, district, and the state level.

Scope of Work

Currently the scope of project is limited with high level below items planned in phase wise activities:

ASHA functional Modules
Comprehensive RMNCH+A Module
Automating ASHA Incentive master claim form
ASHA Dashboard
ASHA Work Plan

Users of the system

S. No	Primary Actor	Role
1	ASHA	Household survey, Registration, Follow-ups and mobilization
2	ANM	Primary Care, Maternal Care and Immunization

In Scope ASHA Functional Modules

Household Enumeration
Family Members Registration
Eligible Couple Registration
Eligible Couple Tracking
Maternal Health

Pregnant Women Registration
Antenatal Care
Delivery Outcome
Postnatal Care

Child Care

Infant and Child Registration
Routine Immunization
Adolescent Care

Non-Communicable Diseases (NCD) screening
Tuberculosis (TB) screening
Disease control Module
High-risk Assessment Module

Pregnant Women Assessment and Follow-up
Non-Pregnant Women Assessment and Follow-up

Death Reports

Child Death Review (CDR)
Maternal Death Surveillance and Response (MDSR)

ASHA Dashboard
ASHA Work Plan (To-do List)

App Functionality

This app supports multiple Languages, like Hindi, English and Assamese. Which is maintained through the "strings" file for every language.

Household and beneficiary Registration Functionality

While registering beneficiary, app has two flows.

Newborn/Child/Adolescent typically till 14 years.
General Registration is from 15 years and above.

Lists sections and type of Lists and condition

Different types of lists are created based on the beneficiary registrations. These are defined in the following data fields: "Age", "Gender", "Marital Status", "CBAC Score" and family folder concept.

All Household List
All Beneficiaries List
Eligible Couple List: 15 years to 49 years, female, married
Pregnancy Women List: Women list who are pregnant
Delivery Stage List: Women list who are in the delivery stage
Postnatal Care (PNC) List: Women who delivered and with 42 days of after delivery date.
NCD List: All beneficiaries but CBAC Form access is not given
NCD Eligible List: All Beneficiary both Male and Female whose age > = 30 years and excluding PW; with CBAC Form access
NCD Priority List: Beneficiary age > = 30 years and CBAC assessment score is greater than 4
NCD Non-Eligible List: Beneficiary age > = 30 years and CBAC assessment score is less or equals to 4
Reproductive Age List: List of Women who are eligible for give birth/ ability to get pregnant /eligible for reproduction. I.e. Women belonging to age group of 15 – 49 years.

Process of Generating Beneficiary Ids

App is reserving 500 beneficiary IDs in the local database; these IDs are generated using an API (generateBeneficiaryIDs) based on the algorithm defined in AMRIT. Generation of beneficiary Ids happen while logging in to the app by passing a count in API (currently passing count 100 as static value). So, in the response we will get 100 beneficiary IDs and stores in the local database, which we will call as "reserved beneficiary IDs".
Online Beneficiary Registration: When a beneficiary is registered online then it takes "new beneficiary ID" and generates directly from the server. This doesn't take any ID from the reserved beneficiary ID.
Offline Beneficiary Registration: When a beneficiary is getting registered offline then it takes the "beneficiary ID" from the reserved beneficiary IDs and when app gets the network it gets replaced with online beneficiary ID and the online beneficiary ID gets replaced and saved in the mobile.
HHID Generation:
Household Id (HHID) is created based on the logic in the code. Logic of generating HHID is below:
(DD(date))(MM(Month))(YYYY(Year))(HH(Hour))(MM(Minute))(SS(Seconds))(AshaId)
Example: House Hold Id: 22012023072323539

Door-to-door Survey

System Validations

New Household Registration

Incentive Logic: ASHA will receive an extra ₹1500 for completing the household line listing at the beginning of the year and updating it after every six months

Family Details

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	First Name of Head of the family	Textbox	Is Mandatory	Input method: Speech to Text feature Accept alphabets only Character limit 50 All letter should be in caps
2	Last Name/ Surname	Textbox		Input method: Speech to Text feature Accept alphabets only Character limit 50 All letter should be in caps
3	Mobile No of Head of the family	Textbox	Is Mandatory	Accept numeric (integer) value only Accept 10 digits only Should not start form zero Should start with digit 6, 7, 8 or 9 Should Not accept all same digits
4	House No	Textbox		Allow Alphanumeric Character and special Characters Character limit 100
5	Ward No	Textbox		Allow Alphanumeric Character and special Characters Character limit 100
6	Ward Name	Textbox		Allow Alphanumeric Character and special Characters Character limit 100
7	Mohalla Name	Textbox		Allow Alphanumeric Character and special Characters Character limit 100
8	Economic Status	Spinner	Is Mandatory Choose: APL BPL Don't know

House Hold Details

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Type of Residential area	Spinner	Choose: Rural Urban Tribal Tea Garden Other
2	Other Type of Residential area	Textbox		Enable if other is selected above Is Mandatory if other is selected above Allow Alphanumeric Character and special Characters Character limit 100
3	Type of House	Spinner	Is Mandatory Choose: Kuchha Pucca None Other
4	House ownership	Spinner	Is Mandatory Choose: Yes No

House Hold Amenities

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Separate Kitchen	Spinner	Is Mandatory Choose: Yes No
2	Type of Fuel used for cooking	Spinner	Is Mandatory Choose: Firewood, Crop Residue, Cow Dung Cake, Coal, Kerosene, LPG, Other
3	Other type of fuel used for cooking	Textbox		Enable if other is selected above Is Mandatory if other is selected above Allow Alphanumeric Character and special Characters Character limit 100
4	Primary Source of water	Spinner	Is Mandatory Choose: Tap Water, Handpump Inside House, Handpump Outside House, Well, Tank, River, Pond, Other
5	Other Source of Water	Textbox		Enable if other is selected above Is Mandatory if other is selected above Allow Alphanumeric Character and special Characters Character limit 100
6	Availability of Electricity	Spinner	Is Mandatory Choose: Electricity Supply, Generator, Solar Power, Kerosene Lamp, Other
7	Other Availability of electricity	Textbox		Enable if other is selected above Is Mandatory if other is selected above Allow Alphanumeric Character and special Characters Character limit 100
8	Availability of Toilet	Spinner	Is Mandatory Choose: Flush Toilet with Running Water, Flush Toilet without Water, Pit Toilet with Running Water Supply, Pit Toilet without Water Supply, Other, None
9	Other Availability of Toilet	Textbox		Enable if other is selected above Is Mandatory if other is selected above Allow Alphanumeric Character and special Characters Character limit 100
	After Household registration is completed, show below alert in pop: "Do you want to proceed with registration of Head of the family"; "Yes" or "No" If "Yes", navigate to the Beneficiary Registration If "No", land back to Household list screen

Family member Registration

In family members registration, priority should be given first to head of the family (HoF), once HoF member is registered allow other family members registration.
After Household registration is completed, check whether HoF is registered or not, if HoF is not registered take to HoF registration else family member registration
There should be relationship with HoF while registering family members to auto fill some details
There should also be relationship with Wife/ Husband/ Father, etc while registering respective member to auto fill some details

Beneficiary Registration

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
	** Every Beneficiary Registration should be linked with any one of the Household (HHID)**
	** Beneficiary Registration is two types, based on the Age, that is as below Adult Registration: Age 15 years and above Newborn/ Child/ Adolescent Registration: Age 0 to less than 15 Years * Based on the selected Age, fields in the form changes respectively as mentioned here in the logic column
I	Adult Registration (Age 15 years and above)
1	Head of family Registration OR Family Member Registration			Show this sub heading based on the type of member registration
2	Photo	Camera	Is Optional	Should have face detection/ Facial recognition Camera should identify & capture human face but not any objects Show an Alert if Photo is not captured, just as reminder but Not Mandatory Alert: "Do you like to Take Photo", Yes or No If "Yes", open Camera; If "No", go to next
3	Date of Registration	Calendar/ Date Picker	Is Mandatory Choose the date from the calendar Format: dd-mm-yyyy Default value Today's Date	Not greater than Today's Date should not allow date less than 1/1/2020 should not allow to update in edit or once submitted
4	Relationship with head of family		Self	Place of order of this field should change bases on the type of registration, as below In case of HoF registration, auto select "Self" and show it here or just show title In case of family member registration, show this field after "Gender" field
5	Beneficiary Status	Radio Button	Choose: Alive Death Default value is “Alive”	Enable only in the “Edit” Beneficiary screen Default value is “Alive” If “Death” is selected, enable below four fields and mark it mandatory 1. Date of Death 2. Time of Death 3. Reason for Death 4. Place of Death And finally, if “Death” is selected, then move this record to Death Reports Show Alert: Cause of Death to be reported to ANM/MPW/PHC for death review.
6	Date of Death	Date picker	§ Conditionally Mandatory	§ Show only above value is “Death” § By default, date is null § Not greater than Today’s Date § Accept ‘Date of Death’ after date of registration
7	Time of Death	Time picker	Not Mandatory	§ Show only above value is “Death”
8	Reason for Death		§ Conditionally Mandatory	§ Show only above value is “Death”
9	Place of Death		Conditionally Mandatory Choose: Home Subcenter PHC CHC District Hospital Medical College Hospital Private Hospital In Transit Other Place of Death	§ Show only above value is “Death” § If ‘Place of Death’ is selected as “Other Place of Death” then enable below field “Other Place of Death” and is mandatory.
10	Other Place of Death	Textbox	Conditionally Mandatory	Enable only above value is “Other Place of Death”
11	First Name	Textbox	Is Mandatory	In case of HoF registration, auto select from HH details Input method: Speech to Text feature Accept alphabets only Character limit 50 All letter should be in caps
12	Last Name/ Surname	Textbox	Is Mandatory	In case of HoF registration, auto select from HH details Input method: Speech to Text feature Accept alphabets only Character limit 50 All letter should be in caps
	Select: Date of Birth OR Age
13	Date of Birth	Calendar Date Picker	Is Mandatory	Auto Calculate 'Age' based on the DOB entered Allow Age 15 years and above
14	Age (in Years)	Textbox	Is Mandatory	Auto Calculate 'Date of Birth' based on the Age entered Allow Age 15 years and above Character limit 2
15	Gender	Spinner	Is Mandatory Choose: Male Female Transgender	Based on the Gender selected, show below family relationships
16	Relationship with head of family	Spinner	Is Mandatory Choose: (this is sample List, get this list form old app or currently what we have) Example: for Male Son, Husband, Father, Nephew, Son-in-law, Brother, Grandson, Grand Father, Father-in-law, others Example: for Female Wife, Daughter, Mother, Niece, Daughter-in-law, Sister, Grand Daughter, Grand Mother, Mother-in-law, others	In case of HoF registration, hide this field (NA) In case of family member registration, show this field after "Gender" field Show all family relationships based on the Gender criteria, as below When Gender is Male or Transgender, show all male relationships When Gender is Female, show all Female relationships Whomever you are registering his/her relation should selected here
17	Other Relationship with head of family	Textbox		In case of HoF registration, hide this field (NA) Enable if other is selected above Is Mandatory if other is selected above Enable if other is selected above Is Mandatory if other is selected above
18	Mobile Number of	Spinner	Is Mandatory Choose: Self, Husband, Father, Mother, Family head, others	In case of HoF registration, hide this field (NA) If married and Male show Wife If married and Female show Husband If unmarried don't show above both
19	Enter Relation with Mobile Number	Textbox		In case of HoF registration, hide this field (NA) Enable if other is selected above Is Mandatory if other is selected above Enable if other is selected above Is Mandatory if other is selected above
20	Mobile Number	Textbox	Is Mandatory	In case of HoF registration, auto select from HH details Show after 'Mobile Number of' is selected If "Family head" is selected above, then auto populate Mobile Number of 'Head of the family' Similarly, for other relationships Husband" or "Wife"
21	Marital Status	Spinner	Is Mandatory Choose: Unmarried Married Divorced Separated Widow Widower	Not Applicable for Newborn/ Child/ Adolescent (Age 0 to less than 15 Years) Show this field once above Gender is selected If "Unmarried" is selected hide below three fields from S. No. 15, 16, 17 Based on the 'Gender' values in this dropdown list should change as follows: In case of 'Gender' = "Female" show "Widow" and hide "Widower" In case of 'Gender' = "Male" show "Widower" and hide "Widow" Above in field 'Relationship with head of family' is selected as "Husband" or "Wife" then auto select "Married"
22	Husband's/ Wife's Name	Textbox	Is Conditionally Mandatory	In case of "Married" and any one is already registered, then auto select Name from 'Husband' or 'Wife' details; base on the Relationship with Hof Input method: Speech to Text feature Hide this field in case of 'Marital Status' = "Unmarried" Optional (Not Mandatory) in case of 'Marital Status' = "Divorced" Based on the Gender show label name as: 'Husband's' or 'Wife's Name' Accept alphabets only Character limit 50 All letter should be in caps
	Date of Marriage	Calendar Date Picker	Is Conditionally Mandatory	In case of "Married" and any one is already registered, and date if available then auto select from 'Husband' or 'Wife' details; base on the Relationship with Hof Hide this field in case of 'Marital Status' = "Unmarried" Show only when below 'Age at Marriage' is equal to above 'Actual Age'
	Age at Marriage	Textbox	Is Mandatory	Hide this field in case of 'Marital Status' = "Unmarried" Accept numbers only Character limit 2 digits Allow Age greater or equals to 15 Years Marriage Age should Not be greater than actual Age
	Father's Name	Textbox	Is Conditionally Mandatory	Base on the Relationship with Hof, in case of Son or Daughter auto populate Name Input method: Speech to Text feature Optional (Not Mandatory) in case of 'Gender' = "Female" and 'Marital Status' = "Married" Accept alphabets only Character limit 50 All letter should be in caps
	Mother's Name	Textbox	Is Conditionally Mandatory	Base on the Relationship with Hof, in case of Son or Daughter auto populate Name Input method: Speech to Text feature Optional (Not Mandatory) in case of 'Gender' = "Female" and 'Marital Status' = "Married" Accept alphabets only Character limit 50 All letter should be in caps
	Community	Spinner	Is Mandatory Choose: General SC ST OBC OC Not Given	By default, auto select get form HoF But it should be editable
	Religion	Spinner	Is Mandatory Choose: Hindu Muslim Christian Sikhism Buddhism Jainism Parsi Other Not disclosed	By default, auto select get form HoF But it should be editable
	RCH ID	Textbox		12-digit unique number Accept numeric (integer) value only Character limit up to 12 Show this field only for 'Gender' = "Female" and 'Gender' = "Male" for Child (Age 0 to less than 15 Years) That field is Not Applicable for 'Gender' = "Male" for Age above 15 Years)
II	Below field are only applicable for Newborn/ Child/ Adolescent Registration (Age 0 to less than 15 Years)
	Select: Date of Birth OR Age
25	Date of Birth	Calendar Date Picker	Is Mandatory	Auto Calculate 'Age' based on the DOB entered Allow Age 0 to less than 15 Years
26	Age	Textbox	Is Mandatory	Auto Calculate 'Date of Birth' based on the Age entered Allow Age 0 to less than 15 Years Character limit 2 It is Mandatory to select below 'Age Unit' If Age is greater than 3 Years of Age (less than 15 Years), then enable this field below: Is the Child Registered at School? (S. No. 28)
27	Age Unit	Textbox	Is Mandatory Choose: Days (s) Month (s) Year (s)	When 'Age' is selected above, it is Mandatory to select 'Age Unit' In case of 'Date of Birth' is entered, auto select related value "Days (s)/ Month (s), Year (s)"
28	Is the Child Registered at School?	Spinner	Is Mandatory Choose Yes No	If Age is greater than 3 Years of Age (less than 15 Years), then enable this field If "Yes" is selected, then select 'Type of School/ Institution'
29	Type of School/ Institution	Spinner	Is Mandatory Choose: Anganwadi Primary Secondary Private	Enable if "Yes" is selected above Is Mandatory if other is selected above
	Birth Details
30	RCH ID	Textbox		12-digit unique number Accept numeric (integer) value only Character limit up to 12
31	Birth Certificate No.	Text Box	Default value should be Null	Accept numeric value and special characters Character limit 50
32	Place of Birth	Spinner	Is conditionally Mandatory Choose: Home Sub-Centre PHC CHC Sub-District Hospital, District Hospital, Medical College Hospital In Transit Private Hospital Accredited Private Hospital Other

Status of Woman

Condition: For Beneficiaries whose Gender is "Female" and Age should be 15 years and above.

Definition:

Eligible Couple, Pregnant Woman, Postnatal Mother and Permanently Sterilised this status of woman is applicable for Women between Age 15 to 49 Years.
Elderly Woman: Women Age 50 years and above
Adolescent Girl: Girls between Age 10-19 years

S No

Name of Data Field

Field Type

Value/ Options

Validation/ Logic/ Condition

1

Status of Women

Spinner

Is Mandatory
Choose:

Eligible Couple (1)
Pregnant Woman (2 & 3)
Postnatal Mother (4)
Elderly Woman (5)
Adolescent Girl (6)
Permanently Sterilised (7)

The options in the "Status of Women" field should be based on Age criteria as per four conditions defined in the below table.

Old List Items:

Eligible Couple (1)
Antenatal Mother (2)
Delivery Stage (3)
Postnatal Mother-Lactating Mother (4)
Menopause Stage (5)
Other (6)

The options in the "Status of Women" field should be based on Age criteria as defined in the below 4 conditions:

Condition-1

Condition-2

Condition-3

Condition-4

Show "Adolescent Girl" for age 15 to 19 years

Elderly Women (Age 50 years and above)

Women Age 15 to 49 Years

If Age is 15 to 19 years, show only below options:

Adolescent Girl
Eligible Couple
Pregnant Woman
Postnatal Mother
Permanently Sterilised

After age 20 years, the "Adolescent Girl" option should be disabled

Display "Elderly Woman" only for individuals age 50 years and above.

Show only below options:

Eligible Couple
Pregnant Woman
Postnatal Mother
Permanently Sterilised

Conditions in Edit Beneficiary:

In beneficiary record, “Age” edit is allowed only with in the age group of selected ‘Status of Women’ category
Edit of ‘Status of Women’ is not allowed

i.e. if ‘Status of Women’ = “Eligible Couple” then “Age” edit is allowed between Age 15-49 Years

OTP Consent Mechanism

Enter the "Mobile Number of the Head of the Family" and enable the green "Send OTP" button to request an OTP via SMS. If it fails, use the "Refresh" button to resend it. In online mode, this button is available in New Household and Family Member Registrations, and shows a "Verify OTP" button in All Beneficiaries if pending. OTPs are 4 digits and must be entered within 15 minutes; valid OTPs show "OTP Verified successfully," while invalid or expired ones show "Session Expired," requiring a new request. In offline mode, the button is disabled; forms can be saved as drafts with an orange "Verify OTP" button, which opens the consent form for editing. Household submissions won't sync or generate an ID until consent is verified. OTP status is indicated with an orange icon for "Pending," a red icon for "Not Done," and a green icon for "Done.

Name of Data Field	Field Type	Field Type	Validation/ Logic/ Condition
Contact Number of /Mobile Number of Head of Family	Text		After entering the "Mobile number of the Head of the Family," enable the "Send OTP" button
Send OTP	Button		This Button should be in green on right corner below Contact Number. It initiates a request to generate OTP & send OTP Via SMS to the Registered mobile number In case of failed attempt, clicking on "Refresh button"
Refresh	Button		Regenerate OTP and send to the Registered mobile number
OTP Verification	Textbox		A)Online Mode 1.New Household Registration: After entering the "Mobile number of the Head of the Family," enable the "Send OTP" button in green on right corner 2.Family Member Registration: Under "Members," after entering the Contact Number, enable the "Send OTP" button in green. 3.All Beneficiaries: If OTP verification is pending, display a navigation button to "Verify OTP." 4.OTP Verification Details Allowed OTP: Numerical codes only, 4 digits long. Verification Process: Verify OTP against the generated code. Set a 15-minute time limit for OTP entry. Valid OTP within timeframe: Display "OTP Verified successfully." Invalid OTP or timeout: Display "Session Expired" ASHA needs to request a new OTP in subsequent visits. Not validated from server: Keep in draft mode 5.Enable Mode (During Internet Availability) Display a green "Send OTP" button. If no OTP is received, allow editing of the mobile number and resending the OTP. C)Offline Mode 1.New Registration: After entering the mobile number, Disable the "Send OTP" button. Allow form submission and save as draft. On the card, display a "Verify OTP" navigation button beside the contact number in orange. This beneficiary should not sync to the server. Clicking the button opens the consent form in edit mode with no data loss. 2.Household Submission Do not sync or generate an ID until the Head of Family's consent management is completed and verified.. D)OTP Verification Status Indicators 1.Verification Pending: Orange icon with text beside the contact number. 2.Verification Not Done: Red icon with text in the right corner of the card. 3.Verification Done: Green icon with text. Additional Features Auto-Submit: Automatically submit once all OTP digits are entered. Auto-Close: Close the card after OTP verification attempt (successful or unsuccessful).

Eligible Couple Module

Married couple wherein the wife is in the reproductive age group (i.e. 15 - 49 years of age) are considered as Eligible Couple (EC).
Registration of an Eligible couple is done by ASHA after a door to door survey in her catchment area every year.
Eligible couple Tracking is done by ASHA after registering couple, in every financial year on monthly basis till Woman is conceived.
This module includes:

Eligible Couple Registration
Eligible Couple Tracking

Eligible couple Registration

Condition: If Status of Woman is "Eligible Couple".

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Date of Registration	Calendar Date Picker	Is Mandatory Choose the date from the calendar Format: dd-mm-yyyy Default value Today's Date	Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
2	RCH ID No. of Woman	Text Box	Default as 0	12-digit unique number Accept numeric (integer) value only Character limit up to 12
3	Name of Woman	Text Box		Auto fill from beneficiary details
4	Name of Husband	Text Box		Auto fill from beneficiary details
5	Current Age of Woman	Custom Number Picker	Accept Integer Value	Character limit 2 Accept values from 10 to 50
6	Age of Woman at Marriage	Custom Number Picker	Accept Integer Value	Character limit 2 Accept values from 10 to 50 Value should be less than or equal to current age
	Details of Woman	label
7	Bank AC No or Post Office AC No	Edit Text Box	Default value 0	Accept numeric (integer) values only Accept value greater than 0 (Account Number Accepting the value greater than zero) Character limit of 20 digits
8	Bank Name	Text Box		Accept alphabets Character limit 50
9	Branch Name	Text Box		Accept alphabets Character limit 50
10	IFSC Code	Text Box		11-digit alpha numeric code Not Mandatory, even Account Number is entered
11	Total No. of Children Born	Custom Number Picker	Default Value 0	Accepts values from 0 to 9 Auto increment the value, when this Women give Birth to a Baby
12	No. of Live Children	Custom Number Picker	Default Value 0	Accepts values from 0 to 9 Auto increment the value, when this Women give Birth to a Live Baby in the Delivery Outcome section
13	Details of 1st Child	label		If Total No. of Children Born = "1" If Total No. of Children Born is greater than "1" Then repeat the below 4 fields based on the "No of Children" (i.e. S. No. 15, 16, 17, 18) with respective Child count
14	1st Child Date of Birth	Calendar Date Picker		Auto Calculate 'Age' based on the DOB entered Allow Age up to 15 Years
15	1st Child Age	Custom Number Picker		Auto Calculate 'Date of Birth' based on the Age entered Allow Age up to 15Years Character limit 2
16	1st Child Sex	Spinner	Choose: Male Female
17	Gap between Date of marriage and 1st child	Text Box		The difference between Date of Marriage and 1st child date of birth in month (Auto calculate and display) Incentive Logic: ADD Rs 500 Per case, incentive for ASHA if gap between Marriage(Marriage Date =calculate Age at marriage of beneficiary &Age of beneficiary at 1^st child Birth)marriage and 1^stChild Date of Birth = 2years.
18	Details of 2nd Child	label		If Total No. of Children Born = "1"
19	2nd Child Date of Birth	Calendar Date Picker		Auto Calculate 'Age' based on the DOB entered Allow Age up to 15 Years
20	2nd Child Age	Custom Number Picker		Auto Calculate 'Date of Birth' based on the Age entered Allow Age up to 15 Years Character limit 2
21	2nd Child Sex	Spinner	Choose: Male Female
22	Gap between 1st child and 2nd child	Text Box		The difference between 1st child date of birth and 2nd child date of birth in month (Auto calculate and display) Incentive Logic : ADD Rs 500 Per case ,incentive for ASHA if gap between 1st Child Date of Birth and 2nd Child Date=3years
23	Male	Text Box		Read only field Show value based on above selection Accept only if 'Total No. of Live Children' data field is greater than "0". Should be less than "Total No. of Children Born – Male". Auto increment the value, when this Women give Birth to a Baby Boy (Male) from Infant section
24	Female	Text Box		Read only field Show value based on above selection Accept only if "Total No. of Children - Male & Female" data field is greater than 0. Should be less than "Total No. of Children Born – Female". Auto increment the value, when this Women give Birth to a Baby Girl (Female) from Infant section

Eligible couple Tracking

This tracking is done for every Eligible couple on monthly basis with below questioner

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1.	Date of Visit	Calendar Date Picker	Is Mandatory Choose the date from the calendar Format: dd-mm-yyyy Default value Today's Date	Not greater than Today's Date Accept date greater or equal to Date of EC registration should not allow to update in edit or once submitted
2.	Financial Year	Auto-populated	Default Null	Depends on Date of visit visit date based Financial Year
3.	Visit Month	Spinner	Select Month Default value is current Month	Auto select current Month And should be editable
4.	Is Pregnancy Test done?	Radio Button	Default Value null Yes No Don't Know - D	If "Is Pregnancy Test done?" = "Yes", then the "Pregnancy Test Result" field should be enabled and made mandatory. If “Is Pregnancy Test done?” = “No”, then hide the field ‘Is the Woman Pregnant?’ and If “Is Pregnancy Test done?” = “No” OR “Don’t Know”, then enable “Are you using any Family Planning Method?” field below.
5.	Pregnancy Test Result	Radio Group	Choose: Negative Positive Default value Null	Default Value null If ‘Pregnancy Test Result’ = “Positive” then the field ‘Is the Woman Pregnant?’ set to “Yes” and then move the EC to ‘Pregnant Woman’ section for PW Registration. Then, ‘Status of Woman’ should change to “Pregnant Woman”. If ‘Pregnancy Test Result’ = “Negative”, then ‘Is the Woman Pregnant?’ set to “No” and hide this field and then enable “Are you using any Family Planning Method?” field below.
6.	Is the woman pregnant?	Radio Group	Default Value null Yes - Y No - N Don't Know (Remove)	If "No", enable "Are you using any Family Planning Method?" field below. If "Yes", then move the EC to 'Pregnant Woman' section for PW Registration Then, Status of Woman should change to "Pregnant Woman"
7.	Are you using any Family Planning Method?	Radio Group	Options as Yes / No	Default Value null if "Yes" is chosen, enable "Method of Contraception" field below
8.	Method of Contraception	Spinner	Self ANTRA Injection Copper T (IUCD) Condom Mala N Chaya ECP Any Other Method	Default Value null Open "Any Other Method" Text Box on selection of "Any Other Method" option and is mandatory. If “ANTRA Injection” is selected, then enable three fields below ‘ANTRA Injection’ “Dose”, “Date of Injection” and “Due date of next Injection” Incentive Logic: I. Antara Prog: ASHA receives incentive as follows: "ASHA incentive for accompanying the client for Injectable MPA (Antara Prog) administration"; S. No. 38 to 42. for 1st dose, ASHA receives Rs. 100 per as an incentive. [FMR Code 3.1.1.2.8] for Activity S. No. 38 in claim from for 2nd dose, ASHA receives Rs. 100 per as an incentive. [FMR Code 3.1.1.2.8] for Activity S. No. 39 in claim from for 3rd dose, ASHA receives Rs. 100 per as an incentive. [FMR Code 3.1.1.2.8] for Activity S. No. 40 in claim from for 4th dose, ASHA receives Rs. 100 per as an incentive. [FMR Code 3.1.1.2.8] for Activity S. No. 41 in claim from for More than 4th dose, ASHA receives Rs. 100 per as an incentive. [FMR Code 3.1.1.2.8] for Activity S. No. 42 in claim from II. Social Marketing: ASHA receives Incentives of Rs 1 per patient for Home Delivery Contraceptive-Condom Incentives of Rs 1 per patient for Home Delivery Contraceptive-Oral pills (if "Chaya" is selected) Incentives of Rs 2 per patient for Home Delivery Contraceptive-EC
	Any Other Method	Edit Text Box	Default Value Null	Accept alphabets only Character limit 50
	ANTRA Injection - Dose	Spinner	Mandatory Select options: 1st Dose 2nd Dose 3rd Dose 4th Dose 5th Dose to 10th Dose	Enable only “ANTRA Injection” is selected above
	Date of ANTRA Injection	Calendar	Mandatory	Enable only “ANTRA Injection” is selected above
	Due date of next Injection	Label		Enable only “ANTRA Injection” is selected above The difference between two doses should not be less than 75 days and more than 120 days. If gap is more than 120 days, the beneficiary has to register for 1st dose Auto-calculate this due date range calculation Logic: Date of ANTRA Injection + 76 Days up to Date of ANTRA Injection + 120
	MPA Card	File upload		Enable only if ‘Method of Contraception’ = “ANTRA Injection” is selected.
	MPA Card	View Image	Option to view images
	Submit	Button
	ANTRA Injection Details	Table		Show only “ANTRA Injection” is given above Show these details in the table: Dose, Date, Next due date for every Injection dose

Maternal Health

Step 1: ASHA capture beneficiary details in survey register during door-to-door survey twice in a year and register are updated on monthly basis.
Step 2: ANM develop village profile in RCH register.
Step 3: ANM creates duelist from RCH register or MCP card after consultation with ASHA every month at the end of VHSND session and are updated at the beginning of the session

ASHA uses the "Nikshay Kit" to confirm pregnancy of women at sub-center or VHSND site or home visit.
After confirmation of pregnancy, ANM register beneficiary and issues MCP card to pregnant women.

Step 4: Anti Natal Check-up: ANM examine pregnant women and update MCP card and ASHA updates due list which is verified by ANM. The ANC is performed to identify the HRP case.

Pregnant Women Registration

Condition: If Status of Woman is "Pregnant Women"

S. No	Name of data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Date of Registration	Calendar Date Picker	Is Mandatory Choose the date from the calendar Format: dd-mm-yyyy Default value Today's Date	Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration Don't allow date not less than 280 days from Today's Date Do not allow to update in edit or once submitted
2	RCH ID No. of Woman	Text Box	Default as 0	12-digit unique number Accept numeric (integer) value only Character limit up to 12
3	MCP Card No	Text Box	Default as 0	12-digit unique number Accept numeric (integer) value only Character limit up to 12
4	Name of Pregnant Women			Auto-populate
5	Name of Husband			Auto-populate
6	Current Age of Woman			Auto-populate
7	LMP Date	Calendar	Is Mandatory	Accept date not less than 10 months 280 days from Today's Date Not greater than Today's Date And this LMP Date is editable For Edit LMP: any one of the conditions is applicable Allow to edit till 26 Weeks of Pregnancy Or till ANC-2 is not submitted Whichever is first
8	Weeks of Pregnancy at the time of PW Registration	Text Box		Auto Calculated based on the LMP date and date of PW registration and convert to weeks Read only
9	EDD	Text Box		Auto Calculated based on the LMP date Formula: LMP Date + 280 days
10	Blood Group	Spinner	Choose: A +ve B +ve AB +ve O +ve A -ve B -ve AB -ve O -ve
11	Weight of PW (Kg)	Number Picker		Accept numeric (integer) value only Accept values from 30 to 200 Weight of PW (Kg) at time of PW Registration
12	Hight of PW (Cm)	Number Picker		Accept numeric (integer) value only Accept values from 50 to 200 Hight of PW (cm) at time of PW Registration
13	VDRL/RPR Test result	Spinner	Choose: Reactive Non-Reactive Test Not Done
14	Date of VDRL/RPR Test done	Calendar	Choose the date from the calendar Date Format: dd-mm-yyyy	Accept date equal to or greater than Date of PW Registration. Accept Date of PW registration minus one year Not greater than Today's Date Disable if "Test Not Done"
15	HIV Test result	Spinner	Choose: Reactive Non-Reactive Test Not Done
16	Date of HIV Test done	Calendar	Choose the date from the calendar Date Format: dd-mm-yyyy	Accept date equal to or greater than Date of PW Registration. Not greater than Today's Date Disable if "Test Not Done" Accept Date of PW registration minus one year
17	HBsAg Test result	Spinner	Choose: Positive Negative Test Not Done
18	Date of HBsAg Test done	Calendar	Choose the date from the calendar Date Format: dd-mm-yyyy	Accept date equal to or greater than Date of PW Registration. Not greater than Today's Date Disable if "Test Not Done" Accept Date of PW registration minus one year
19	Past Illness	Multi select checkbox list	Is Mandatory Choose: None TB Diabetes Hypertension Heart Disease Epileptic STI/RTI Hepatites-B Asthama Any Other	Default value is "None" If any other is selected "None" should unselect.
20	Any other	Textbox	Accept alphabets only Character limit 50	Enable if other is selected above Is Mandatory if other is selected above
21	Is this your 1st pregnancy?	Spinner	Mandatory Choose: Yes No	If "Yes" is selected, then disable below all fields from S. No. 22 If "No" is selected, then enable below all fields from S. No. 22
22	Total no. of previous Pregnancy	Number Picker		Accept numeric Accepts values from 0 to 15
23	Any complications in Last Pregnancy	Spinner	Choose: None Convulsions APH Pregnancy Induced Hypertension (PIH) Repeated Abortion Stillbirth Congenital Anomaly Caesarean Section Blood Transfusion Twins Obstructed Labour PPH Any Other	Enable if "No" is selected in "Is this your 1st pregnancy?" Default value is "None" If "Any other" is selected enable below field 'Any other Complication' and is mandatory
24	Any other Complication	Text Box	Accept alphabets only Character limit 50
25	Is Identified as HRP cases?	Radio button	Choose: Yes No	If "Yes" is selected, enable below field "Who had identified HRP?" and is Mandatory If "Yes" then Add the Woman name in the "HRP List" Display the name in the PMSMA list Highlight the Pregnant Women in Red colour in the Pregnant Women List Then flag as HRP Case and show in scheduler till Delivery
26	Who had identified as HRP?	Spinner	Is conditionally Mandatory Choose: ANM CHO PHC – MO Specialist at Higher Facility	Enable only if "Yes" is selected above, If "Yes" is selected above, then it is Mandatory

Ante Natal care visits

The definition and schedule (Standard protocol) for antenatal visits during pregnancy are as follows:

ANC 1 (1^st Visit): Within 12 weeks of pregnancy
ANC 2 (2^nd visit): Within 14 to 26 weeks of pregnancy
PMSMA Visit is applicable for all Pregnant Women whose ANC 1 is done and PW who are Identified as HRP cases
ANC 3 (3^rd visit): Within 28 to 32 weeks of pregnancy
ANC 4 (4^th visit): Between 36 to 40 weeks / expected date of delivery (EDD)

In case of high-risk pregnancy, PW may go for more than four visits to the health facility for ANC checkups.
Condition:
Perform 4 ANC Visits, after each ANC checkup move the record to next ANC
Allow access to view and edit each ANC Visit
For each ANC Visit, show ANC completed list and ANC due list
Logic for ANC due list of Pregnant Women:

ANC 1: List of Women whose Pregnant Women Registration is done and 'weeks of pregnancy' is < = 12 weeks (84 Days from LMP Date)
ANC 2: List of Women whose ANC 1 is done and 'weeks of pregnancy' is > = 14 weeks (98 Days from LMP Date) and < 28 weeks (195 Days from LMP Date)
PMSMA Visit: List of Women whose ANC 1 is done and 'weeks of pregnancy' is > = 14 weeks (98 Days from LMP Date) and < = 40 weeks (280 Days from LMP Date) and PW who are Identified as HRP cases
ANC 3: List of Women whose ANC 2 is done and 'weeks of pregnancy' is > = 28 weeks (196 Days from LMP Date) and < 36 weeks (251 Days from LMP Date)
ANC 4: List of Women whose ANC 3 is done and 'weeks of pregnancy' is > = 36 weeks (252 Days from LMP Date) and < = 40 weeks (280 Days from LMP Date)

ANC Visit
Photo	Name:	w/o:	Age:
	Phone No.	MCP No.	RCH Id:
	LMP	EDD

ANC Visit data entry form: here some the fields differ from visit to visit based on the given logic.

S. No.	Name of data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	ANC Date	Date Picker	Is Mandatory Choose the date from the calendar Format: dd-mm-yyyy	Accept Date after 5 weeks from LMP Date Date less than 4 weeks from Last ANC Date must not be allowed. Accept date greater than Last ANC Date. Not greater than Today's Date And Not greater than Date “42 weeks of Pregnancy”; i.e. maximum Date is 42 weeks from LMP Date
2	Weeks of Pregnancy	Text Box		Auto calculated Auto Calculate from LMP date to till current ANC Date and convert to weeks Read only Incentive Logic: ASHA incentive of Rs 50 gets added for 1^st time registration of beneficiary ,when the "Weeks of Pregnancy" field Auto-populates between 1 to 12 weeks. (FMR-3.1.1.1.13)
3	ANC Period	Spinner	Choose: ANC 1 ANC 2 ANC 3 ANC 4 ANC 5 ANC 6 ANC 7 ANC 8	Should be editable, based on User choice Default Value is auto select based on below conditions Display ANC 1, if "ANC Date" is within 12 weeks from LMP Date. Display ANC 2, if "ANC Date" is between 14- 26 weeks from LMP Date. Display ANC 3, if "ANC Date" is between 28-32 weeks from LMP Date. Display ANC 4, if "ANC Date" is between 36 weeks up to EDD from LMP Date. Incentive Logic: ASHA incentive of Rs 100 gets added when ANC Period is chosen With ANC1 ,ANC2 , ANC3 and ANC4 is completed for a beneficiary [FMR code-3.1.1.1.13]
4	Abortion If Any	Radio Group	Choose: No Yes	Open "Abortion Date", "Abortion Type" and "Facility" data field on selection of Yes option and are mandatory. Default Value is "No" If "Yes", then Woman should be again moved to Eligible couple Tracking section Incentive Logic: If Abortion is marked as "Yes", eligible for below incentive In Incentive Master Claim Form under 'Maternal Health' section, S. No. 18 "ASHA incentive for Comprehensive Abortion Care", Rs 150 per case
5	Abortion Type	Spinner	Choose: Induced Spontaneous Incomplete Default value – 0	If Abortion is "Yes" this field is Mandatory
6	Facility (Place of Abortion)	Spinner	Conditionally Mandatory Choose: Home Subcenter PHC CHC District Hospital Medical College Hospital Private Hospital In Transit Other Place of Death	If Abortion is "Yes" this field is Mandatory
7	Abortion Date (Date of Termination)	Date Picker	Choose the date from the calendar Format: dd-mm-yyyy	If Abortion is "Yes" this field is Mandatory Accept date between 5 weeks to 20 weeks from LMP Date Not greater than Today's Date Disable the ANC detail Fields "Weight of PW (Kg)", "BP of PW (mm Hg) – Systolic/Diastolic"," Pulse Rate", "HB (gm/dl)", "Fundal Height / Size of the Uterus (in weeks)"," Urine Albumin"," Random Blood Sugar Test"," Date of Td / TT (1^st Dose)", "Date of Td / TT (2^nd Dose)", "Date of Td / TT (Booster Dose)","No. of Folic Acid Tabs given"," Any High Risk conditions"," High Risk conditions"," Referral Facility", Is HRP Confirmed?"," Who had identified as HRP?"," Maternal Death"," Probable Cause of Death" ,"Other Death Cause" "Death Date", "Has the pregnant woman delivered?"," Next ANC Visit Date"
	Serial no as per Admission/ Evacuation register	Text Box		If Abortion is "Yes", then show this field Accept numeric value and special characters Character limit 10
	Method of Termination	Spinner	Options MVA EVA MMA Others	If Abortion is "Yes", then show this field
	Termination done by	Spinner	Options Doctor Nurse	If Abortion is "Yes", then show this field
	Post Abortion Contraception Is PAIUCD inserted after an abortion?	Radio button	Options Yes No	If Abortion is "Yes", then show this field Incentive Logic: If "Yes" is selected, eligible for below Incentive In Incentive Master Claim Form under 'Family Planning' section S. No. 47, "For motivating PAIUCD", Rs. 150 per Abortion case
	Remarks	Multiline Text Box		If Abortion is "Yes", then show this field Allow Alphanumeric Character and special Characters Character limit 100
	Abortion Discharge Summary	File upload	§ Option to upload Two images	If Abortion is "Yes", then show this field Update with latest images
	Abortion Discharge Summary	View Image	§ Option to view images	If Abortion is "Yes", then show this field
	CAC Form (Filed Not required)			If Abortion is "Yes" only, applicable for Incentive claim This is a consolidated form to be generated for all Abortion cases in a month, with below columns: CAC Form: Serial no as per Admission/ Evacuation register, Type of Abortion, Date of Termination, Duration of Pregnancy, Method of Termination, Termination done by, Facility, Post Abortion Contraception, Remarks
8	Weight of PW (Kg)	Custom Number Picker	Accept numeric (integer) value only Values from 30 to 200
9	BP of PW (mm Hg) – Systolic	Edit Text Box	Accept numeric (integer) value only Values from 50 to 300 Default value 0	Default Value: to be null if no data is entered Mandatory if "BP Diastolic (mm Hg)" filled. Systolic: < 90 or >= 140 is HRP Case
10	BP of PW (mm Hg) - Diastolic	Edit Text Box	Accept numeric (integer) value only Values from 30 to 200 Default Value 0	Default Value: to be null if no data is entered. Mandatory if "BP Systolic (mm Hg)" filled. Systolic should be greater than Diastolic Diastolic: < 60 or >= 90 is HRP Case
11	Pulse Rate	Edit Text Box		Accept numeric (integer) value only Accept values upto 3 digits Do not allow decimals
12	HB (gm/dl)	Custom Number Picker	Accept numeric (integer) value up to one decimal place only Values from 2.0 to 15.0	Default Value: to be null if no data is entered Severe Anemia (Hemoglobin is less than 7 gm/dl)
13	Fundal Height / Size of the Uterus (in weeks)	Custom Number Picker	Must accept numeric (integer) value only Character limit 2 Default value null	Disable field up to 12 Weeks of Pregnancy. Accept numeric (integer) value only Accept values upto 2 digits Do not allow decimals
14	Urine Albumin	Radio button	Choose: Absent Present	Default Value - null
15	Random Blood Sugar Test	Radio button	Choose: Not Done Done	. Default Value - null
16	Date of Td / TT (1^st Dose)	Date Picker	Choose the date from the calendar Format: dd-mm-yyyy	Accept date between 5 weeks from LMP Date up to 36 Week of LMP Not greater than Today's Date Default Value: to be null if no data is entered. Disable this data field if "Date of TD Booster Dose" is entered in the Last ANC Visit.
17	Date of Td / TT (2^nd Dose)	Date Picker	Choose the date from the calendar Format: dd-mm-yyyy	Accept date after 4 weeks from TD 1 Date up to 36 weeks of LMP If Td1 (1^st dose) is given then display the Given Date If Td2 (1^st dose) is given then display the Given Date If "TD 2^nd Dose" is given in the Last ANC Visit, then display a message "All TD doses are given" Not greater than Today's Date Default Value: to be null if no data is entered. Enable this data field if "Date of TD 1^st Dose" is entered in the Last ANC Visit. Disable this data field if "Date of TD Booster Dose" is entered in the Last ANC Visit. If "TD 2^nd Dose" is given in the Last ANC Visit, then message as "All TD doses have been given" must appear alongside the data field.
18	Date of Td / TT (Booster Dose)	Date Picker	Choose the date from the calendar Format: dd-mm-yyyy	Accept date between 5 weeks from LMP Date up to up to 36 Week of LMP Not greater than Today's Date Default Value: to be null if no data is entered. Disable this data field if "Date of TD 1^st Dose" is entered in the Last ANC Visit. If "Date of TD Booster Dose" is entered in the Last ANC Visit, then message as "All TD doses have been given" must appear alongside the data field.
19	No. of Folic Acid Tabs given	Custom Number Picker	Must accept numeric (integer) value only Default Value 0	Disable field if Weeks of Pregnancy is greater than 12 weeks Accept value up to 60 No
20	No. of IFA tabs given	Custom Number Picker	Must accept numeric (integer) value only Default Value 0	Disable field up to 12 Weeks of Pregnancy. Default Value: to be null if no data is entered Accept value up to 400 No
21	Any High Risk conditions	Radio Button	Options Yes No	If "Yes" is selected, then enable "High Risk conditions" drop down below If "Yes", then flag this Woman as HRP Case and show in the scheduler till Delivery
22	High Risk conditions	Drop Down List	Choose: NONE HIGH BP (SYSTOLIC >=140 AND OR DIASTOLIC >=90 mmHg) CONVULSIONS VAGINAL BLEEDING FOUL SMELLING DISCHARGE SEVERE ANAEMIA (HB <7 gm/dl) DIABETES TWINS OTHER	If "OTHER" is selected, then enable "Any Other High Risk conditions" Text Box below and is mandatory. Default value is "NONE"
23	Any other High Risk conditions	Text Box	Accept alphabets only Character limit 50
24	Referral Facility	Spinner	Choose: Primary Health Centre Community Health Centre District Hospital Other Private Hospital
25	Is HRP Confirmed?	Radio Button	Choose: No Yes	If "Is HRP Confirmed?" = "Yes" then Add the Woman name in the "HRP List" Display the name in the PMSMA list Highlight the Pregnant Women in Red colour in the Pregnant Women List Then flag as HRP Case and show in scheduler till Delivery
26	Who had identified as HRP?	Spinner	Is conditionally Mandatory Choose: ANM CHO PHC – MO Specialist at Higher Facility	Enable only if "Yes" is selected above, If "Yes" is selected above, then it is Mandatory
27	Maternal Death	Radio Button	Choose: No Yes	Default value is "No" If “Yes” is selected, enable below three fields and mark it mandatory Probable Cause of Death Date of Death Place of Death If "Yes" is selected, then move this record 'MDSR' section If "Yes" is selected, update 'Beneficiary Status' = "Death" in the Beneficiary record, with “Date of Death ”, "Place of Death" and “Probable Cause of Death” in Beneficiary table and sync to AMRIT
28	Probable Cause of Death (Reason for Death)	Spinner	Choose from A. ECLAMPSIA B. HAEMORRHAGE C. HIGH FEVER D. ABORTION E. OTHER	If "OTHER" is selected, then enable "Other Death Cause" Text Box below and is mandatory. Probable Cause of Death means Reason for Death
29	Other Death Cause	Text Box	Accept only alphabets Character limit 50	Enable only if "OTHER" is selected above and is mandatory.
30	Date of Death	Calendar	Choose the date from the calendar Format: dd-mm-yyyy	Show only above 'Maternal Death' “Yes” and is Mandatory Not greater than Today's Date Should be less than EDD Greater than LMP date Greater than last visit date
31	Place of Death		Conditionally Mandatory Choose: Home Subcenter PHC CHC District Hospital Medical College Hospital Private Hospital In Transit Other Place of Death	Show only above 'Maternal Death' “Yes” and is Mandatory If ‘Place of Death’ is selected as “Other Place of Death” then enable below field “Other Place of Death” and is mandatory.
32	Other Place of Death	Textbox	Conditionally Mandatory	Enable only above value is “Other Place of Death”
33	Has the pregnant woman delivered?	Radio Button	Choose: Yes No	Default value "No" Disable up to 22 weeks of pregnancy. If "Yes" is selected, then move record to 'Delivery Outcome' Section
34	Next ANC Visit Date	Calendar	Choose the date from the calendar Format: dd-mm-yyyy	Greater than Today's Date Should be < = EDD Greater than current visit date Show this PW on this Date in the To-do List

Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
On 9th of every month, ANC drive is being conducted at all major facilities.
Beneficiaries can be taken here during 2nd and 3rd trimester of the month.
Incentive Logic: ASHA receives an incentive of Rs. 100 / PMSMA day.

PMSMA Form

Condition: This PMSMA Visit is applicable for all Pregnant Women whose ANC 1 is done

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
Details of Pregnant women
1	MCTS Number/RCH Number (if Registration Number is not available)	Textbox		Auto populate 'RCH Number' form PW record
2	Does the beneficiary have an MCP card?	Radio button	Select: Yes No
	If No is selected, MCP card is given	Radio button	Select: Yes No
3	Husband's Name	Textbox	Non-Mandatory	Accept alphabets only Character limit 50 All letter should be in caps
4	Address	Textbox	Non-Mandatory	Accept numeric value, alphabets and special characters Character limit 100
5	Mobile number	Textbox	Auto populate from 'Beneficiary Registration'	Accept numeric (integer) value only Accept 10 digits only Should not start from zero Should start with digit 7, 8 or 9 All digits should not be same
6	Write the number of ANC's done before delivery	Textbox	Non-Mandatory	Auto-Populate
	Status of the Mother
7	Weight (Kg)	Textbox	Non-Mandatory	Accept numbers only Values from 30 to 200 Character limit 3
	HRP Case, please visit the nearest HWC or call 104
8	Systolic Blood Pressure	Textbox		Accept numbers only Character limit 3
9	Diastolic Blood Pressure	Textbox
10	Abdominal Check-up (Gestational Age in weeks)	Textbox		Calculate the difference between "Date of ANC" and "LMP Date" and display information in weeks
	Fetal Status
11	Fetal heart rate per minute	Textbox
12	Twins pregnancy	Radio Button	Radio button: Yes No
	Investigations
13	Urine Albumin	Textbox
14	Hemoglobin	Textbox
15	HIV	Textbox
16	VDRL	Textbox
17	HBSG (Hepatitis B)	Textbox
18	Malaria	Textbox
19	Was the HIV test done during ANC Checkup?	Radio Button	Radio button: Yes No
20	Swollen condition	Radio Button	Radio button: Yes No

21	Blood sugar test	Radio Button	Radio button: Yes No
22	Ultrasound	Radio Button	Radio button: Yes No
	Intervention Details
23	Iron Folic Acid	Radio Button	Radio button: Yes No
24	Calcium supplementation	Radio Button	Radio button: Yes No
	Tetanus Toxoid	Spinner	First Second Booster
	LMP
25	Last Menstrual Period	Calendar		Last Menstrual Period (LMP) Auto populate form PW record
26	Expected Date of Delivery	Textbox	Is Mandatory	Expected Date of Delivery (EDD) Auto populate form PW record
	Identification of high-risk factors
27	Identification of high-risk symbols	Radio Button	Radio button: Yes No	If yes, select the reason given below
28	If yes, select reason given below and write	Textbox
29	Pregnant in high risk category treated	Radio Button	Radio button: Yes No
30	Pregnant in high risk category was referred	Radio Button	Radio button: Yes No
	Advice
31	Preparation for birth and complications, nutrition and family planning	Radio Button	Radio button: Yes No
32	Name of Medical Officer in charge	Textbox
33	Save	Button		Check all validation and Mandatory fields

Delivery Outcome

Condition: In ANC visit, if 'Is pregnant woman delivered' is "Yes", open these details.

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
	Date of Delivery	Date Picker	Choose the date from the calendar Format: dd-mm-yyyy	Accept date 21 weeks from LMP Date Accept date greater or equal to Date of Last ANC Date. Accept date equal to or up to 25 days from EDD. Not greater than Today's Date
	Time of Delivery	Time Picker	Accept numeric (integer) values only. Format: hh-mm Default value is null
	Place of Delivery	Spinner	Choose from District Hospital – 5 Community Health Centre – 2 Primary Health Centre – 1 Sub Centre – 24 Other Public Facility – 19 Accredited Private Hospital – 20 Other Private Hospital – 21 Home – 22 Sub District Hospital – 4 Medical College Hospital 17 In Transit – 23	Incentive Logic: If this women is Identified as HRP and Place of delivery is other than "Home" and "In Transit" then ASHA receives an incentive of Rs 100 to be added [FMR Code 3.1.1.1.13]
	Type of Delivery	Drop Down List	Choose: Normal Caesarean Assisted
	Complications during Delivery?	Radio Button	Options as Yes / No	Default value is "No"
	Delivery Complication	Spinner	PPH RETAINED PLACENTA OBSTRUCTED DELIVERY PROLAPSED CORD TWINS PREGNANCY CONVULSIONS DEATH Other Delivery Complication DON'T KNOW	Enable only above field "Delivery Complication" = "Yes" and is mandatory Default value is select. If "Other Delivery Complication" is selected then open below 'Text Box' for "Other Delivery Complication" and is mandatory If “Death” is selected, enable below three fields and mark it mandatory Probable Cause of Death Date of Death Place of Death If "Death" is selected, update 'Beneficiary Status' = "Death" in the Beneficiary record, with “Death Date”, "Place of Death" and “Probable Cause of Death” in Beneficiary table and sync to AMRIT If "Death" is selected, then move this record to 'MDSR' section If "Death" is selected, then don't move this record to PNC If "Death" is selected, case is closed
	Other Delivery Complication	Text Box	Accept only alphabets and special character. Character limit 50	Enable only "Other Delivery Complication" is selected above and is mandatory
	Date of Death	Calendar	Choose the date from the calendar Format: dd-mm-yyyy	Show only above 'Death' is selected and is Mandatory Not greater than Today's Date Greater than LMP date
	Place of Death		Conditionally Mandatory Choose: Home Subcenter PHC CHC District Hospital Medical College Hospital Private Hospital In Transit Other Place of Death	Show only above 'Death' is selected and is Mandatory If ‘Place of Death’ is selected as “Other Place of Death” then enable below field “Other Place of Death” and is mandatory.
	Other Place of Death	Textbox	Conditionally Mandatory	Enable only above value is “Other Place of Death”
7	Probable Cause of Death (Reason for Death)	Spinner	Choose: Eclampcia Haemorrahge Obstructed Labour Prolonged Labour High Fever Other	If "Other" is selected, then Open "Other Death Cause" Text Box and is mandatory. Probable Cause of Death means Reason for Death
8	Other Death Cause	Text Box	Accept only alphabets and special character. Character limit 50
9	Outcomes of Delivery	Custom Number Picker	Accept numeric (integer) value only. Values from 0 – 6.	Delivery Outcome is equal to sum of Live Births and Still Births.
10	Live Birth	Custom Number Picker	Accept numeric (integer) value only Value from 0-6	Accept value less than or equal to "Outcomes of Delivery" only "Live Birth" babies should move to 'Infant Registration' section
11	Still Birth	Custom Number Picker	Accept numeric (integer) value only Value from 0-6	Accept value less than or equal to "Outcomes of Delivery" "Still Birth" babies should NOT move to 'Infant Registration' section "Still Birth" means "Still Birth" baby is death during delivery
12	Date of Discharge	Date Picker	Choose the date from the calendar Format: dd-mm-yyyy	Not greater than Today's Date. Not less than Date of Delivery.
13	Discharge Time	Time Picker	Accept numeric (integer) values only. Format: hh-mm Default value - null
14	MCP Card	File upload	Option to upload Two images	Update with latest images
	MCP Card	View Image	Option to view images
17	Is the Pregnant Woman a JSY Beneficiary?	Radio Button	Choose: Yes / No
	JSY payment voucher	File upload
	Submit	Button		On click show alert box: Show an Alert! “Please upload MCP Card photo to claim your Incentive”

Post-Natal Care Visits of Mother

Condition:

In ANC visit, if 'Is pregnant woman delivered' is "Yes", open these details.
If in Delivery Outcome section 'Delivery Complication' = "Death", then do NOT show this Woman in list.

Note: After Delivery + 42 days, Woman should be again moved to Eligible couple Tracking section

PNC Visit
Photo	Name:	w/o:	Age:
	Phone No.	MCP No.	RCH Id:
	Date of Delivery:

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition

	PNC Period	Spinner	Choose: 1st Day3rd Day7th Day14th Day21st Day28th Day42nd Day	Default value is select.
	PNC Visit Date	Calendar	Choose the date from the calendar Format: dd-mm-yyyy	1st Day - Accept date equal to Delivery Date or up to 1^st days from Delivery Date. 3rd Day – should be strictly given on 3^rd day after delivery 7th Day – Should be given between Delivery + 7 (-3 and +3 ) in days 14th Day - Should be given between Delivery + 14 (-3 and +3) in days. 21st Day - Should be given between Delivery + 21 (-3 and +3 ) in days. 28th Day - Should be given between Delivery + 28 (-3 and +3 ) in days 42nd Day Should be given between Delivery + 42 (-3 and +3 ) in days Not greater than Today's Date Not less than Date of Delivery
	No. of IFA Tablets given	Custom Number Picker	Default value 0	Accept numeric (integer) value only Accept value greater than 0 Accept value up to 400
	Any Method of Contraception	Radio Button	Options as Yes / No	Open "PPC Method" data field on selection of Yes option.
	Method of Contraception	Spinner	Choose: POST PARTUM IUCD (PPIUCD) WITHIN 48 HRS OF DELIVERY CONDOM MALE STERILIZATION FEMALE STERILIZATION POST PARTUM STERILIZATION (PPS WITHIN 7 DAYS OF DELIVERY) ANY OTHER (SPECIFY)	Default value is select. Incentive Logic : If no data is entered. Open "Other Method" Text Box on selection of Any Other (Specify) option and is mandatory. <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="0b0cb2c6-d5b3-484b-ad26-3d74aa2fb166"><ac:plain-text-body><![CDATA3.1.1.2.4]; S.No. 35 in claim from \]></ac:plain-text-body></ac:structured-macro> <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="8fbbfcf7-7bf9-47b7-8b2b-fe73683e75f4"><ac:plain-text-body><![CDATA1.2.2.1.a]; S.No. 40 in claim from \]></ac:plain-text-body></ac:structured-macro> <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="5a4c5307-0573-4000-a7cd-4512e49f37ce"><ac:plain-text-body><![CDATA[* If 'Method of Contraception' = "PPS", then ASHA receives Rs. 300 as an incentive. [FMR Code: 1.2.2.1.a]; S.No. 41 in claim from
6	Other PPC Method	Edit Text Box	Accept alphabets, numeric and special character. Character limit 50
	Mother Danger Sign	Drop Down List	Choose: NoneA. PPHB. FEVERC. SEPSISD. SEVERE ABDOMINAL PAINE. SEVERE HEADACHE OR BLURRED VISIONF. DIFFICULT BREATHING Z. Any Other	Open "Other Danger Sign" Text Box on selection of Any Other (Specify) option and is mandatory. Default Value is "None"
	Other Danger Sign	Edit Text Box	Accept alphabets only Character limit up to 50
	Referral Facility	Spinner	Choose from Primary Health Centre - 1/Community Health Centre - 2/District Hospital - 5/Other Private Hospital - 21/Any Other (Specify) -99
	Mother Death	Radio Button	Choose: Yes No	Default value is "No" If "Yes" is selected, then Disable next PNC Visits and Case is Closed If “Yes” is selected, enable below three fields and mark it mandatory Probable Cause of Death Date of Death Place of Death If "Yes" is selected, update 'Beneficiary Status' = "Death" in the Beneficiary record, with “Death Date”, "Place of Death" and “Probable Cause of Death” in Beneficiary table and sync to AMRIT If "Yes" is selected, then move this record to 'MDSR' section
	Date of Death	Date Picker	Choose the date from the calendar Format: dd-mm-yyyy	Show only above value 'Mother Death' = "Yes" and is mandatory Not greater than Today's Date Not less than Delivery Date
	Probable Cause of Mother Death	Spinner	Choose from ECLAMPSIA HAEMORRHAGE (PPH) ANAEMIA HIGH FEVER Any Other	Show only above value 'Mother Death' = "Yes" Open "Other Death Cause" Text Box on selection of "Any Other" option and is mandatory.
	Other Death Cause	Edit Text Box	Accept alphabets only Character limit 50	Show only above value "Any Other" is selected
	Place of Death	Radio Group	Choose: Home Subcenter PHC CHC District Hospital Medical College Hospital Private Hospital In Transit Other Place of Death	Show only above value 'Mother Death' = "Yes" and is mandatory If ‘Place of Death’ is selected as “Other Place of Death” then enable below field “Other Place of Death” and is mandatory.
	Other Place of Death	Textbox	Conditionally Mandatory	Enable only above value “Other Place of Death” is selected
	Remarks	Text Box	Accept alphabets, numeric and special characters Character limit 250

Micro Birth Plan

High Risk Assessment >> Pregnant Women Section >> Assess High Risk in PW
The Micro Birth Plan is a detailed, personalized plan created for pregnant women to ensure safe delivery. The plan includes:

Identifying the Place of Delivery: Determining the safest Facility for childbirth.
Arranging Transportation: Ensuring reliable transport to the delivery site.
Organizing Blood Donors: Preparing for emergencies by arranging blood donors.

This plan aims to reduce maternal and neonatal risks, ensuring a safer birthing experience.
It Should have Offline capability

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
Micro Birth Plan
1	Name of the PW			Auto-populate
2	Age			Auto-populate
3	Contact No. 1 Contact No. 2	Text Box		Contact No. 1: This number should Auto-fill Contact No. 2: This should be free text and Non-Mandatory; Accept numeric (integer) value only Accept 10 digits only Should not start form zero Should start with digit 6, 7, 8 or 9 Should Not accept all same digits
4	SC/HWC/TG Hosp	Text Box		Accept alpha-numeric values Character limit 100 All letter should be in caps
5	Block	Text Box		Accept alpha-numeric values Character limit 100 All letter should be in caps
6	Husband's Name			Auto-Populate
9	Nearest SC/HWC	Text Box		Accept alpha-numeric values Character limit 100 All letter should be in caps
10	Nearest 24*7 PHC	Text Box		Accept alpha-numeric values Character limit 100 All letter should be in caps
11	Nearest FRU	Text Box		Accept alpha-numeric values Character limit 100 All letter should be in caps
12	Nearest USG centre	Text Box		Accept alpha-numeric values Character limit 100 All letters should be in caps
13	Blood Group	Spinner	Choose: A +ve B +ve AB +ve O +ve A -ve B -ve AB -ve O -ve	Auto Fill if available OR Select form Spinner

14	Blood donors identified	Text Box	Accept alphabets only Character limit 50 All letter should be in caps
15	Birth Companion	Text Box	Accept alphabets only Character limit 50 All letter should be in caps
16	Person who will take care of Children, if any when the PW is admitted for delivery	Text Box	Accept alphabets only Character limit 50 All letter should be in caps
17	Name and Contact number of VHSND/Community member for support during emergency	Text Box	Accept alphabets only Character limit 100 All letter should be in caps
18	Mode of transportation in case of labor Pain	Text Box	Accept Alpha-numeric values Character limit 100 All letter should be in caps
19	Submit	Button	Once submitted, change the Color of button "Micro Birth Plan" to Orange on the Card

The Miro Birth Plan Form Template Format:
Below is a format for a Miro Birth Plan template that can be shared on WhatsApp with staff either on Business Account or Directly
While sharing on what's app show in the Caption: in the Caption
Micro-Birth plan "Header"
ASHA Name: Auto-populate
Subcentre: Auto-populate in SC/HWC/TG Hosp field

Child Care

Infant Registration

Should capture the details of Infants from Delivery Outcome section
From 'Delivery Outcome' section based on the value (No of Live Births) of "Outcomes of Delivery" and "Live Births", Infant Registration should be multiplied, that is for each of the "Live Birth" baby one new 'Infant Registration' section should be created automatically.
Example: for 2 "Live Birth" babies there should be 2 'Infant Registration'


Photo	Woman Name:	w/o:	Age:
	Phone No.	MCP No.	RCH Id:
	Date of Delivery:

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Name of Baby		default Name is 'Baby of' <Mother Name>	Auto-populate, default Name is 'Baby of' <Mother Name> Or 'Baby one of' <Mother Name>, 'Baby Two of' <Mother Name>,
2	Baby Term	Text Box	Mandatory Full Term Preterm	Display Full Term, if Delivery Date is between 37 completed weeks to less than 42 completed weeks w.r.t LMP Date. Display Preterm, if Delivery Date is less than 37 completed weeks w.r.t LMP Date.
3	Sex of Baby	Radio Button	Mandatory Male Female
4	Weight at Birth (kg)	Custom Number Picker	Mandatory Accept numeric (integer) value up to one decimal place only Values from 0.5 to 7.0	If Weight of Baby is Less than 2.5 kg, then treat as Low birth weight (LBW) Baby Then flag as LBW Baby Case and show in scheduler till DoB + 42 days
5	Baby Cried Immediately after Birth	Radio Button	Mandatory Yes No Default - null	Default value null Open "If No, Resuscitation Done" data field on selection of No option and is mandatory.
6	If No, Resuscitation Done	Radio Button	Conditional Mandatory Yes No Default - null	Default value null Mandatory if “No” is selected in above field “Baby Cried Immediately after Birth”
7	Breast feeding started within 1 hour of birth	Radio Button	Mandatory Choose from Yes - Y/No - N
8	Any birth defect seen at birth?	Radio Button	Options as Yes / No	Open "Any defect seen at birth" data field on selection of Yes option.
9	Defect seen at birth	Spinner	Choose: Cleft Lip / Cleft Palate Club Foot Down's Syndrome Hydrocephalus Imperforate Anus Neural Tube Defect (Spinal Bifida) Other	If "Other" is selected, Open "Other defect seen at birth"
10	Other defect seen at birth	Text Box	Accept only alphabets and special character Character limit 50
11	Was Corticosteroid Inj. given?	Radio Button	Options as Yes - Y/ No- N / Don't Know- NA Default - null	Default value null
12	Referred to higher facility	Radio Button	Select: § Yes § No Default – “No”
13	Is Baby discharge from SNCU?	Radio Button	Mandatory Select: § Yes § No Default – “No”	Default value is “No” Note: This selected value should be auto-populated in the HBNC section
14	Discharge Summary	File upload	§ Option to upload Two images	§ Update with latest images
15	Discharge Summary	View Image	§ Option to view images
16	Submit	Button		On click show alert box: Show an Alert! “Please upload Discharge Summary photo to claim your Incentive”
17

Child Registration

This Child Registration should be linked to the House hold of Mother and add in the beneficiary list
Based on the No of Infants Registration with respective to a Mother, Child Registrations should be multiplied, that is for each of the Infants, one new 'Child Registration' section should be created automatically.
Example: for 2 Infants born to a Mother there should be 2 'Child Registration'


Photo	Mother Name:	w/o:	Age:
	Phone No.	MCP No.	RCH Id:
	Date of Delivery:

S No	Name of Data Field		Field Type		Value/ Options		Validation/ Logic/ Condition
		Date of Registration		Date Picker		Choose the date from the calendar Format: dd-mm-yyyy	Not greater than Today's Date Date of Registration should be taken after or equal date of birth
		Name of Child		Edit Text Box		Fetch from Infant registration	default Name is 'Baby of' <Mother Name> Auto-populate, default Name is 'Baby of' <Mother Name> Or 'Baby one of' <Mother Name>, 'Baby Two of' <Mother Name>, Editable Accept alphabets only Character limit 50
		RCH ID No. of Child		Text Box			12 digit unique number Character limit up to 12 *
		Date of Birth					Auto-populate, from Infant details
		Sex of Child		Radio Group		Options as Male- M / Female - F	Auto-populate, from Infant details
		Mother's Name		Text Box		Fetch from Delivery Outcome	Auto-populate, from Infant details
		Father's Name		Text Box		Fetch from Delivery Outcome	Auto-populate, from Infant details
		Whose Mobile Number		Spinner		Choose from Mother - W/Father -H/Others – O	Auto-populate, from Infant details
		Mobile No.		Text Box		Fetch from EC or PW Registration	Auto-populate, from Infant details
		RCH ID No. of Mother		Edit Text Box			Auto-populate, from PW details
		Birth Certificate No.		Text Box		Default value should be Null	Accept numeric value and special characters Character limit 50
		Weight at Birth (kg)		Custom Number Picker		Accept numeric (integer) values only, up to 1 decimal place. Values from 0.5 to 7.0
		Place of Birth		Spinner		Choose: District Hospital – 5 Community Health Centre – 2 Primary Health Centre – 1 Sub Centre- 24 Other Public Facility 19 Accredited Private Hospital – 20 Other Private Hospital – 21 Home-22 Sub District Hospital – 4 Medical College Hospital – 17 In Transit- 23

HBNC: Home Based Newborn Care

Home Based Newborn Care (HBNC) programme was launched aiming to reduce Neonatal mortality and morbidity rates especially in rural, remote areas where access to care is largely unavailable or located faraway.
Under this programme, ASHA to make visits to all newborns according to specified schedule up to first 42 days of life. This includes six visits in case of institutional deliveries and seven visits in case of home deliveries (1st Day) on 3rd, 7th, 14th, 21st, 28th and 42nd days after birth. Additional visits for babies who are pre-term, low birth weight or ill and SNCU discharged babies will be conducted.

During the visit, ASHA will do the following activities:

Information and skills to the mother and family on how to do better care of newborn, on special care for low weight babies, on how to identify danger signs and promote exclusive breastfeeding and immunization
Examining every newborn for prematurity and low birth weight, identification of illness, anything unusual in baby, provision of appropriate care at home, refer to ANM or nearest health facilities as defined in the protocols
Follow up for sick newborns after they are discharged from facilities
recording of weight of the newborn in Mother Child Protection (MCP) card
ensuring BCG, 1st dose of OPV and DPT vaccination
both the mother and the newborn are safe till 42 days of the delivery, and
registration of birth has been done
Counseling the mother on postpartum care, recognition of postpartum complications and enabling referral
Counseling the mother for adoption of an appropriate family planning method

Note:
Condition:

Note:

Condition:

Show this HBNC section only for beneficiaries whose Age is 0 to 42 Days and HBNC visit transactional history records.
Once HBNC is selected, show below subsections (Home Visit cards):
- Home Visit Card: Day – 1 to Day – 42
- Enable sequentially one after another seven ‘Home Visit’ cards for 1st,3rd, 7th, 14th, 21st, 28thand 42nd days
- Do not enable / show at a once all seven Home Visit cards
- First enable Day – 1 ‘Home Visit’ card, after submitting Day-1 form then enable Day – 3 ‘Home Visit’ card, like this enable one after another up to Day – 42 ‘Home Visit’ card
- It is mandatory to submit Day – 1, Day – 3, Day – 7 and Day-42 ‘Home Visit’ cards
- After Day – 7 visit, Day –14, Day –21 and Day –28 visits are not mandatory
- After Day – 7 visit, Day –14, Day –21, Day –28 and Day-42 ‘Home Visit’ cards should be enabled
ASHA incentive of 250 per case for Providing HBNC up to 42 days after birth / discharge from SNCU; [FMR Code 3.1.1.1.3]; S. No. 1 in master claim form is applicable
ASHA Incentive of Rs.200 per case for follow up of SNCU discharge babies and for follow up of LBW babies, for providing HBNC service up to 42 days after birth for a Baby; [FMR Code 3.1.1.1.4]; S. No. 3 in master claim form is applicable

Table: 1

Name of Baby		Baby details auto-populate If Name is not registered; Auto-populate, default Name is ‘Baby of’ <Mother Name> Or ‘Baby one of’ <Mother Name>, ‘Baby Two of’ <Mother Name>
Photo	Mother’s Name:	Father’s Name:	Date of birth, Age and Gender
	Phone No.	RCH Id (Child):	RCH Id (Mother):
	Care of Baby - Home Visit Card

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	HBNC Visit Day	Spinner	§ Mandatory Choose: 1st Day 3rd Day 7th Day 14th Day 21st Day 28th Day 42nd Day/ 6th Week	§ Default value is select. § If any ‘Visit Day’ or previous visit is submitted, then don’t show that ‘Visit Day’ in the spinner for next visit § ‘Visit Day’ should be incremental
2	HBNC due Date	label	Show date as per schedule visit	§ Auto-populate this due date by calculating using below logic § After selecting above ‘HBNC Visit Day’ and calculate this date from ‘date of Delivery’ Logic for HBNC due Date: § 1st Day: date equal to date of Delivery or Birth of Baby (DoD). § 3rd Day: date equal to 3^rd day after delivery date (DoD + 2 days). § 7th Day: date equal to 7^th day after delivery date (DoD + 6 days). § 14th Day: date equal to 14^th day after delivery date (DoD + 13 days). § 21st Day: date equal to 21^st day after delivery date (DoD + 20 days). § 28th Day: date equal to 28^th day after delivery date (DoD + 27 days). § 42nd Day: date equal to 42^nd day after delivery date (DoD + 41 days). § Not greater than Today’s Date § Not less than Date of Delivery
3	Visit Date	Calendar	§ Mandatory § Choose the date from the calendar § Format: dd-mm-yyyy	§ By default, date is null. § or date when HBNC Visit is due § Not greater than Today’s Date § Accept ‘Visit Date’ on or after date of Delivery or Birth of Baby § Visit Date should be greater than or equals to above respective ‘HBNC due Date’ § Date of ‘next visit’ should be incremental § Date of ‘next visit’ should not be less than ‘previous visit’ date (always should be greater than ‘previous visit’ date)
4	Is the Baby alive?	Radio Button	Choose: § Yes § No Default value is “Yes”	Default value is “Yes” If “No” is selected, enable below three fields and mark it mandatory Date of Death Reason for Death Place of Death If “No” is selected, next follow-up home visits should be disabled (i.e. Visit day 3,7,14,21,28,42). If “No” is selected, disable all below fields form S. No. 9 to 24. If "Yes" is selected, update 'Beneficiary Status' = "Death" in the Beneficiary record, with “Date of Death ”, "Place of Death" and “Probable Cause of Death” in Beneficiary table and sync to AMRIT Show Alert: Cause of Death to be reported to ANM/MPW/PHC for infant death review.
5	Date of Death	Date picker	§ Conditionally Mandatory	§ Show only above value is “No” § By default, date is null § Not greater than Today’s Date § Accept ‘Date of Death’ on or after date of Delivery or Birth of Baby
6	Reason for Death		§ Conditionally Mandatory
7	Place of Death		Conditionally Mandatory Choose: Home Subcenter PHC CHC District Hospital Medical College Hospital Private Hospital In Transit Other Place of Death	If ‘Place of Death’ is selected as “Other Place of Death” then enable below field “Other Place of Death” and is mandatory.
8	Other Place of Death	Textbox	Conditionally Mandatory	Enable only above value is “Other Place of Death”
9	Baby Weight (kg)	Custom Number Picker	§ Mandatory § Accept numeric (integer) value up to one decimal place only § Values from 0.5 to 7.0	If Weight of Baby is Less than 2.5 kg, then treat as Low birth weight (LBW) Baby § Then flag as LBW Baby Case and show in scheduler till DOB + 42 days Show Alert: § If the weight of the baby is less than 2.5 kg, then advise the mother to provide extra warmth to the baby and feed the baby more frequently. § If the weight is less than 1.8 kg then refer the baby to Sick Newborn care unit at the nearest health facility and also conduct extra home visits as per the high-risk baby form. § If the baby (low birth weight or normal) is not gaining weight then refer to SNCU at the nearest health facility.
10	Urine passed	Radio Button	Mandatory Select: § Yes § No § Default - null
11	Stool passed	Radio Button	Mandatory Select: § Yes § No § Default - null
12	Diarrhoea	Radio Button	Mandatory Select: § Yes § No Default - null
13	Vomiting	Radio Button	Conditional Select: § Yes § No Default - null
14	Convulsions	Radio Button	Mandatory Select: § Yes § No Default - null
15	Activity	Radio Button	Select: § Good § Lethargic Default – null
16	Sucking	Radio Button	Select: § Good § Poor Default – null
17	Breathing	Radio Button	Select: § Fast § Difficult Default – null
18	Chest Indrawing	Radio Button	Select: § Present § Absent Default – null
19	Temperature	Text Box		show Alert: Action to be taken by ASHA: § If the temperature is < 97 degree F^o then advice the mother to keep the baby warm by increasing the room temperature, providing skin to skin contact, putting the baby in a warm bag and frequently feeding the baby. § If the temperature is < 95.9 degree F^o, then give the above mentioned advice and once the baby is warmer then clothe the baby and place in a pre-warmed bed close to the mother. § If the temperature is > 99 degree F⁰ (fever) then look for signs of sepsis. In case signs of sepsis are not present manage only with 1/4th of a spoon of Paracetamol and immediately refer to the SNCU at the nearest health facility.
20	Jaundice	Radio Button	Mandatory Select: § Yes § No Default – null
21	Condition of Umbilical Stump		§ Drying and Color Change § Falling Off § Appears Infected with redness § Swelling § Foul-smelling discharge § Tenderness
22	Is Baby discharge from SNCU?	Radio Button	Mandatory Select: § Yes § No Default – “No”	Default value is “No” § Note: source of this value should be auto-populated form ‘Infant Registration’ section is there is a record available.
23	Discharge Summary	File upload	§ Option to upload Two images	§ Update with latest images
24	Discharge Summary	View Image	§ Option to view images
25	Submit	Button	§	§ On click show alert box: Show an Alert! “Please upload Discharge Summary photo to claim your Incentive”

HBYC: Home Based Care for Young Child

Home-Based Care for Young Child Programme (HBYC) was launched as part of National Health Mission and POSHAN Abhiyan for promotion of health and nutrition of young children (3-15 months), for reducing child morbidity and mortality and for promotion of growth and Early Childhood Development. Under HBYC, ASHA provides incentivized five home visits on 3rd, 6th, 9th, 12th and 15th months. ASHAs are being paid incentive of Rs.250/- per HBYC category child for five scheduled home visits.
During the visit, ASHA will do the following activities:

Counseling for exclusive breast feeding till 6 months and continued breast feeding with adequate complementary feeding afterward
Counseling of mothers and caregivers and support to identify and manage problems related to nutrition and health in their child
Facilitate for early identification of delay in growth and development of children by using the MCP card
Support in prevention and management of common childhood illnesses
Assist in prompt referral of sick children to health facilities for management of complications and follow ups

ASHA will get an incentive of ₹250 per child if the following conditions are met [FMR code:3.1.1.1.12]:

The district selected must be an aspirational district, namely:
The ASHA worker must have submitted the HBYC forms for the 3, 6, 9, 12, and 15-month milestones.

Immunization

This Immunization modules should be available for only below two types of beneficiaries

ANC Women
Children between age group of 0 to 16 years

In the Immunization due list Module show below two sub-sections

ANC Women: show all women whose who are in ANC section
Children: show all Children between age group of 0 to 16 years, show separately children with below Age group:

Birth Dose Vaccines Babies
6 Weeks Vaccines Children
10 Weeks Vaccines Children
14 Weeks Vaccines Children
9-12 Months Vaccines Children
16-24 Months Vaccines Children
5-6 Years Vaccine Children
10 Years Vaccine Children
16 Years Vaccine Children
Catch-Up Vaccines (Missing Vaccines)

When respective child is selected from list, based on the above age corresponding Immunization list is shown as per schedule:

Vaccine Taken: in Green colour;
Vaccine Due: in Orange colour;
Vaccine Overdue: in Red colour

Immunization schedule as per above Age groups

S No	Age	Vaccine Name	Due date	ASHA Incentive Logic
1	Birth Dose	OPV 0 BCG Hepatitis B 0 VITAMIN K	DoB	Incentive Logic: ASHA incentive for ensuring for Full Immunization (0–1 year): Under the “Immunization” section activity, S. No. 12, the term “Full Immunization (0–1 year)” applies when a child receives all of the following eight vaccines before reaching one year of age: BCG 1^st Dose OPV - 1 OPV - 2 OPV - 3 Pentavalent - 1 Pentavalent - 2 Pentavalent - 3 Measles – 1 For each case/ child of full Immunization as defined above, an ASHA incentive of Rs. 100 is applicable (FMR Code-3.1.1.1.11).
2	6 Weeks	OPV-1 PENTAVALENT -1 ROTA 1 IPV 1	DoB + 6 Week
3	10 Weeks	OPV 2 ROTA 2 Pentavalent 2	DoB + 10 Week
4	14 Weeks	OPV 3 Rota 3 Pentavalent 3 IPV 2	DoB + 14 Week
5	9-12 Months	Measles 1 JE 1 Vitamin A – 1	DoB + 9 Month
6	16-24 Months	Measles 2 OPV Booster DPT Booster 1 JE 2 Vitamin A – 2 Vitamin A – 3	DoB + 16 Month	Incentive Logic: Ensuring for complete Immunization (1 - 2 years): Under the “Immunization” section activity, S. No. 13, the term “complete Immunization (1 - 2 years)” applies when a child receives all of the following Three vaccines before reaching two year of age: Measles - 2 OPV Booster DPT Booster 1 For each case/ child of complete Immunization as defined above, an ASHA incentive of Rs. 75 is applicable (FMR Code 3.1.1.1.11)
7	5-6 Years	DPT Booster 2 Vitamin A - 3 Vitamin A - 4 Vitamin A - 5 Vitamin A - 6 Vitamin A - 7 Vitamin A - 8 Vitamin A – 9	DoB + 5 Years For each dose of Vitamin A minimum 6 months gap is required	Incentive Logic: Ensuring for DPT immunization (5 years): Under the “Immunization” section activity, S. No. 14, the term “Ensuring for DPT immunization (at 5 years)” applies when a child receives “DPT Booster 2” vaccines at age between 5 - 6 years. For each case/ child as defined above, an ASHA incentive of Rs. 50 is applicable (FMR Code 3.1.1.1.11)
8	10 Years	TD Dose	DoB + 10 Years
9	16 Years	TD Dose	DoB + 16 Years

Immunization data entry screen

For every above Vaccine below fields are applicable:

S No	Name of the Data Field	Field Type	Value/option	Validation/ Logic/ Condition
Child details
1	Name		default Name is ‘Baby of’ <Mother Name>	Name of Baby/ Child or Auto-populate, default Name is ‘Baby of’ <Mother Name>
2	Mother’s Name	Label		Auto-populate
3	Father’s Name	Label		Auto-populate
4	Date of birth of Baby	Label		Auto-populate
5	Age	Label		Auto-populate
6	Gender	Label		Auto-populate
7	Beneficiary Id	Label		Auto-populate
8	Child RCH Id	Label		Auto-populate
9	Mobile No	Label		Auto-populate: Mother’s/ Father’s/ HoF Mobile No
Vaccine Details
10	Dose Name	Label		Auto-Populate from Master
11	Vaccine Name	Label		Auto-Populate from Master
12	Vaccine due Date	Label		Auto-Populate from Master
13	Date of Vaccination	Calendar	Mandatory Choose the date from the calendar Format: dd-mm-yyyy	By default, date is null. or date when Vaccine is due Not greater than Today’s Date Accept ‘Date of Vaccination’ after or equal date of birth
14	Vaccinated Place	Spinner	Choose: Sub-Centre PHC CHC Sub-District Hospital, District Hospital, Medical College Hospital Private Hospital Accredited Private Hospital VHND Other
15	Vaccinated By	Spinner	Choose: ANM CHO Staff Nurse MO
16	MCP Card	File upload	Option to upload Two images	Update with latest images
17	MCP Card	View Image	Option to view images
18	Submit	Button		On click show alert box: Show an Alert! “Please upload MCP Card photo to claim your Incentive”

Immunization schedule Date logic

Vaccine Name	Due date	Date Logic	Dependencies	Due date Work Plan	Over Due period
OPV 0 Dose	DoB	DoB + 15 Days	No	DoB	DoB + 15 Days
BCG	DoB	DoB + 1 Year	No	DoB	DoB + 1 Year
Hepatitis B 0	DoB	DoB + 1 day	No	DoB	DoB + 1 day
Vit K	DoB	DoB + 1 day	No	DoB	DoB + 1 day
OPV 1	DoB + 6 Week	Accept date between 6 weeks form date of Birth to 2 Years	No	DoB + 6 Week	DoB + 2 Yrs
Pentavalent 1	DoB + 6 Week	Accept date between 6 weeks form date of Birth to 1 Year	No	DoB + 6 Week	DoB + 1 Yrs
ROTA 1	DoB + 6 Week	Accept date between 6 weeks form date of Birth to 1 Year	No	DoB + 6 Week	DoB + 1 Yrs
IPV 1	DoB + 6 Week	Accept date between 6 weeks form date of Birth to 1 Year	No	DoB + 6 Week	DoB + 1 Year
OPV 2	OPV1 + 4 Week (age > 6 week)DoB + 10 Week (Age <= 2 Year)	1. Accept date after interval of 4 weeks (28 Days) from date of OPV 12. Accept date between 10 weeks from Date of Birth up to 2 Years from Date of Birth	OPV1	DoB+10 Week	DoB + 2 Yrs
Pentavalent 2	Penta 1 + 4 Week (age > 6 week)DoB + 10 Week (Age <= 1 Year)	1. Accept date after interval of 4 weeks (28 Days) from date of Pentavalent 12. Accept date between 10 weeks from Date of Birth up to 1 Year from Date of Birth	Pentavalent 1	DoB+10 Week	DoB + 1 Year
OPV 3	OPV2 + 4 Week	1. Accept date after interval of 4 weeks (28 Days) from date of OPV 2.2. Accept date between 14 weeks from Date of Birth up to 2yrs from Date of Birth	OPV2	DoB+14 Week	DoB + 2 Yrs
Pentavalent 3	Penta 2 + 4 Week	1. Accept date after interval of 4 weeks (28 Days) from date of Pentavalent 2.2. Accept date between 14 weeks from Date of Birth up to 1 Year from Date of Birth	Pentavalent 2	DoB+14 Week	DoB + 1 Year
ROTA 2	ROTA 1 + 4 Week	1. Accept date after interval of 4 weeks (28 Days) from date of Rota 12. Accept date between 10 weeks from Date of Birth up to 1yrs from Date of Birth	ROTA 1	DoB+10 Week	DoB + 1 Year
ROTA 3	ROTA 2 + 4 Week	1. Accept date after interval of 4 weeks (28 Days) from date of Rota 22. Accept date between 14 weeks from Date of Birth up to 1yrs from Date of Birth	ROTA 2	DoB+14 Week	DoB + 1 Yrs
IPV 2	IPV 1 + 8 Week	Accept date after interval of 8 weeks (56 Days) from date of IPV 1 up to 1 yrs from Date of Birth	IPV 1	DoB+14 Week	DoB + 1 Yrs
OPV Booster – 1	DoB + 16 Month	Accept date between 16 months to 24 months from date of birth maximum up to 2yrs from date of birth	No	DoB + 16 Month	DoB + 2 Yrs
DPT Booster -1	DoB + 16 Month	Accept date between 16 months to 24 months from date of birth maximum up to 7yrs from date of birth	No	DoB + 16 Month	DoB + 7 Yrs
DPT Booster – 2	Dob + 5 Years	Accept date between 5yrs to 7yrs from date of birth	No	Dob + 5 Years	DoB + 7 Yrs
Measles – 1	DoB + 9 Month	Accept date between completed 9 months from date of birth maximum up to 5yrs from date of birth	No	DoB + 9 Month	DoB + 5 Yrs
Measles – 2	DoB + 16 Months	Accept date between 16 months to 24 months from Date of Birth maximum up to 5yrs from Date of Birth	No	DoB + 16 Months	DoB + 5 Yrs
JE Vaccine – 1	DoB + 9 Months	Accept date between completed 9 months from date of birth maximum up to 1yr from date of birth	No	DoB + 9 Months	DoB + 1 Yrs
JE Vaccine – 2	DoB + 16 Months	Accept date between 16 months to 24 months from Date of Birth maximum up to 5yrs from Date of Birth	No	DoB + 16 Months	DoB + 5 Yrs
Vitamin A – 1	DoB + 9 Months	Accept date between completed 9 months from date of birth maximum up to 5yrs from date of birth	No	DoB + 9 Months	DoB + 5 Yrs
Vitamin A – 2	Vitamin A1 + 9 Months	1. Accept date between 16 months from date of birth maximum up to 5yrs from date of birth2. Accept date after interval of 9 months from date of VITAMIN A-1	Vitamin A1	DoB + 16 Month	DoB + 5 Yrs
Vitamin A – 3	Vitamin A2 + 6 Months	1. Accept date between 2 Yrs from date of birth maximum up to 5yrs from date of birth2. Accept date after interval of 6 months from date of VITAMIN A-2	Vitamin A2	DoB + 2 Yrs	DoB + 5 Yrs
Vitamin A – 4	Vitamin A3 + 6 Months	1. Accept date between 2 Yrs and 6 Month from date of birth maximum up to 5yrs from date of birth2. Accept date after interval of 6 months from date of VITAMIN A-3	Vitamin A3	DoB + 2.5 Yrs	DoB + 5 Yrs
Vitamin A – 5	Vitamin A4 + 6 Months	1. Accept date between 3 Yrs from date of birth maximum up to 5yrs from date of birth2. Accept date after interval of 6 months from date of VITAMIN A-4	Vitamin A4	DoB + 3 Yrs	DoB + 5 Yrs
Vitamin A – 6	Vitamin A5 + 6 Months	1. Accept date between 3 Yrs and 6 months from date of birth maximum up to 5yrs from date of birth2. Accept date after interval of 6 months from date of VITAMIN A-5	Vitamin A5	DoB + 3.5 Yrs	DoB + 5 Yrs
Vitamin A – 7	Vitamin A6 + 6 Months	1. Accept date between 4 Yrs from date of birth maximum up to 5yrs from date of birth2. Accept date after interval of 6 months from date of VITAMIN A-6	Vitamin A6	DoB + 4 Yrs	DoB + 5 Yrs
Vitamin A – 8	Vitamin A7 + 6 Months	1. Accept date between 4 Yrs and 6 Month from date of birth maximum up to 5yrs from date of birth2. Accept date after interval of 6 months from date of VITAMIN A-7	Vitamin A7	DoB + 4.5 Yrs	DoB + 5 Yrs
Vitamin A – 9	Vitamin A8 + 6 Months	1. Accept date between 5 Yrs from date of birth maximum up to 7yrs from date of birth2. Accept date after interval of 6 months from date of VITAMIN A-8	Vitamin A8	DoB + 5 Yrs	DoB + 7 Yrs

Immunization schedule for Pregnant Woman

S. No.	Vaccine/Vitamin/Medicine	Minimum period as per NIS	Max. period for' Due' Work plan	Period for 'Over Due' work plan
	Td-1	Early in pregnancy	Up to 36 weeks of pregnancy	Not to be given after 36 weeks of Pregnancy
	Td-2	4 weeks after Td-1	4 weeks after Td-1	Not to be given after 36 weeks of Pregnancy
	Td- Booster**	Early in pregnancy	Up to 36 weeks of pregnancy	Not to be given after 36 weeks of Pregnancy
	Td 10*	10 years	10 years	Not to be given after the age of 16 years
	Td 16*	16 years	16 years	Not to be given after the age of 16 years
	Tab. Folic Acid (FA)*	Within 12 weeks of pregnancy	Up to 12 weeks of pregnancy	Not to be given after 12 weeks of Pregnancy
	Tab. Iron Folic Acid (IFA)	From 12 weeks of pregnancy onwards	Up to expected date of delivery (EDD)	—
	Tab. Iron Folic Acid (IFA)	After the date of delivery	Up to 42 days of delivery	Not to be given after 42 days of delivery

*If a pregnant woman has already been immunized with two doses of Inj. Tetanus-Diphtheria during her previous pregnancy (within the past three years), then only one dose of Inj. Td (as Booster dose) is required as early as possible during her current pregnancy.

Death Reports

Death Reports Module has below two sub sections:

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Select Beneficiary Death type
2	CDR: Child Death Review	Radio button		Navigate to the CDR section: Show list of beneficiaries, where Infant Death or Child Death is noticed, between Age group 0 to 15 years.
3	MDSR: Maternal Death Surveillance and Response	Radio button		Navigate to the MDSR section: Show only list of "Pregnant Women", where in ANC visits the field 'Maternal Death' = "Yes"
4	Continue	Button		Please select any one of the above Death types

Child Death Review

Condition:

Show list of beneficiaries (children), where Child Death is noticed, between Age group 0 to less then 15 years in the Beneficiary list, i.e. 'Beneficiary Status' = "Death".
Infant Death or Child Death is noticed in HBNC or HBYC section from 'Is the Baby alive?' = "No".
Child Death Review (CDR) Form

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Name of the child	Textbox	Auto-populate from Beneficiary details	Auto-populate from Beneficiary details
2	Date of Birth	Textbox
3	Age	Textbox
4	Visit Date	Date	Mandatory
5	Gender	Radio Button:	Select: Female Male Transgender	Auto-populate from Beneficiary details
6	Mother's Name	Textbox
7	Father's Name	Textbox
	Complete Address
8	Address	Textbox
9	House Number	Textbox
10	Mohalla/Colony	Textbox
11	Landmarks, if any	Textbox
12	Pin code	Textbox
	Phone number of parents/family member (Living in same household)			Auto-populate from Beneficiary details
13	Landline	Textbox
14	Mobile Number	Textbox		Auto-populate from Beneficiary details
15	Date of Death	Textbox		Auto-populate from Beneficiary details
16	Time	Textbox
17	Place of Death	Textbox
18	Name of First Informant	Textbox
20	Date of Notification	Textbox
	CDR form from ANM	File upload	Option to upload Two images
	CDR form	View Image	Option to view images
	Death Certificate	File upload	Option to upload Two images
	Death Certificate	View Image	Option to view images
	Submit	Button

Maternal Death Surveillance and Response

Condition:

Show only list of "Women" from below sections with this condition:

In ANC visits the field 'Maternal Death' = "Yes" or
In Delivery Outcome section 'Delivery Complication' = "Death" or
In PNC section 'Mother Death' = "Yes" or 'Beneficiary Status' = "Death"

Maternal Death Surveillance and Response (MDSR) Form

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Date of death	Label		Auto-populate from Beneficiary details
2	Address	Textbox
3	Husband's name	Textbox
4	Cause of death	Radio button Maternal Non-maternal	Default value is "Maternal"	Auto-populate from Beneficiary details or ANC or PNC or Delivery Outcome section If died due to maternal cause, specify reasons
5	If died due to maternal cause, specify reasons	Textbox
6	Date of field investigation	Textbox
7	Action taken	Radio button Yes No
8	Date	Textbox
	MDSR form from ANM	File upload	Option to upload Two images
	MDSR form	View Image	Option to view images
	Death Certificate	File upload	Option to upload Two images
	Death Certificate	View Image	Option to view images
	Submit	Button

Disease Control

Non-Communicable Diseases

Community Based Assessment Checklist (CBAC) Form

NCD (Non-Communicable Diseases) Eligible List:
Show all Beneficiary both Male and Female whose age > = 30 years and excluding Pregnant Women.
And this CBAC Form is applicable to screen these Beneficiaries.
This CBAC Form, assessment check should be done yearly once,
Edit is applicable – but once approved by ANM/MO/ CHO, edit is not applicable
Maintain the history of submitted CBAC Form for viewing, year wise

S No	Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
	CBAC Form
	Date	Calendar Date Picker	Is Mandatory Choose the date from the calendar Format: dd-mm-yyyy Default value Today's Date	Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
	Name	Textbox		Auto fill from Beneficiary details Show: First Name + Last Name Read only
	Age	Textbox		Auto fill from Beneficiary details Read only
	Sex	Textbox		Auto fill from Beneficiary details Read only
	Part A: Risk Assessment
1	What is your Age? (in Age)	Spinner	Is Mandatory Choose: 30 – 39 40 - 49 50 – 59 60 and Above	Auto-populate Age from 'Beneficiary' registration: Score Logic: "Score" is a variable whose Default Score value is "0". If 30 <= Age <= 39 then display "1"If 40 <= Age <= 49 then display "2"If 50 <= Age <= 59 then display "3"If 60 <= Age then display "4"
2	Do you smoke or consume smokeless products such as gutka or khaini	Spinner	Is Mandatory Choose: Never Used to consume in the past sometime now Daily	Score Logic: If option selected "Never" then display "0"If option selected "Used to consume in the past sometime now" then display "1"If option selected = "Daily" then display "2"
3	Do you consume alcohol daily	Spinner	Is Mandatory Choose: Yes No	Score Logic: If "No" then display "0" or If "Yes" then display "1"
4	Measurement of Waist (in cm)	Spinner	Is Mandatory Condition: Show values in the Spinner based on Gender: For Male: Choose: 90 cm or less 91 - 100 cm More than 100 cm For Female: Choose: 80 cm or less 81 - 90 cm More than 90 cm	Score Logic: If "Gender" = "Female" and "Waist length" <= 80 then display "0"If "Gender" = "Female" and 81 <= "Waist length" <= 90 then display "1"If "Gender" = "Female" and "Waist length" > 90 then display "2"If "Gender" = "Male" and "Waist length" <= 90 then display "0"If "Gender" = "Male" and 91 <= "Waist length" <= 100 then display "1"If "Gender" = "Male" and "Waist length" > 100 then display "2"
5	Do you under take any physical activity for minimum of 150 minutes in a week	Spinner	Is Mandatory Choose: At least 150 min in a week Less than 150 min in a week	Score Logic: If "At least 150 min in a week" then display "0" or If "Less than 150 min in a week" then display "1"
6	Do you have any family history (any one of your parents or siblings) of high BP / Diabetes / Heart Disease	Spinner	Is Mandatory Choose: Yes No	Score Logic: If "No" then display "0" or If "Yes" then display "2"
7	Total Score	Label		Total Score Formula: Sum of all above score. Based on the "Total Score" display a message in pop-up as show below: If score is > 4 "Refer to NCD screening day / VHSND/ HWC for NCD screening (Priority)" If score is < = 4 "Refer to NCD screening day / VHSND/ HWC for NCD screening (Less Priority)"
	Part B1: Early Detection Ask if Patient has any of these symptoms
	If "Yes" is selected below then display a pop-up message, "Suspected NCD case, please visit nearest HWC or call 104."
	* If "Yes" is selected for any one of the questions below with "*" then show a pop-up message "Refer to MO and collect the Sputum sample"
	If "Yes" is selected for any one of the questions below with "" then show a pop-up message "Refer to MO or inform ANM/MPW to tracing of all family members"
1	Shortness of Breath	Spinner	Is Mandatory Choose: Yes No
2	Coughing More than 2 weeks *	Spinner	Is Mandatory Choose: Yes No
3	Blood in Sputum *	Spinner	Is Mandatory Choose: Yes No
4	Fever > 2 weeks *	Spinner	Is Mandatory Choose: Yes No
5	Loss of Weight *	Spinner	Is Mandatory Choose: Yes No
6	Night Sweats *	Spinner	Is Mandatory Choose: Yes No
7	Are you currently taking Anti TB drugs **	Spinner	Is Mandatory Choose: Yes No
8	Anyone in Family Currently Suffering from TB **	Spinner	Is Mandatory Choose: Yes No
9	History of TB *	Spinner	Is Mandatory Choose: Yes No
10	Recurrent of ulceration on Palm or Sole	Spinner	Is Mandatory Choose: Yes No
11	Recurrent of tingling on Palm or Sole	Spinner	Is Mandatory Choose: Yes No
12	Cloudy or Blurred Vision	Spinner	Is Mandatory Choose: Yes No
13	Difficulty in reading	Spinner	Is Mandatory Choose: Yes No
14	Pain in eyes lasting for more than weeks	Spinner	Is Mandatory Choose: Yes No
15	Redness in eyes for more than weeks	Spinner	Is Mandatory Choose: Yes No
16	Difficulty in Hearing	Spinner	Is Mandatory Choose: Yes No
17	History of Fits	Spinner	Is Mandatory Choose: Yes No
18	Difficulty in Opening Mouth	Spinner	Is Mandatory Choose: Yes No
19	Ulcers in Mouth Not Healed in 2 weeks	Spinner	Is Mandatory Choose: Yes No
20	Growth in Mouth Not Healed in 2 weeks	Spinner	Is Mandatory Choose:
21	Any white or red Patch in Mouth Not Healed in 2 weeks	Spinner	Is Mandatory Choose: Yes No
22	Pain while chewing	Spinner	Is Mandatory Choose: Yes No
23	Any change in Tone of Voice	Spinner	Is Mandatory Choose: Yes No
24	Any hypo pigmented patches or discolour lesions with loss of sensation	Spinner	Is Mandatory Choose: Yes No
25	Any thickened skin	Spinner	Is Mandatory Choose: Yes No
26	Any nodules skin	Spinner	Is Mandatory Choose: Yes No
27	Any Patch or Discoloration on Skin	Spinner	Is Mandatory Choose: Yes No
28	Recurrent numbness on palm or sole	Spinner	Is Mandatory Choose: Yes No
29	Clawing of fingers in hand or feet	Spinner	Is Mandatory Choose: Yes No
30	Tingling and numbness in hand / or feet	Spinner	Is Mandatory Choose: Yes No
31	Inability to close eye lid	Spinner	Is Mandatory Choose: Yes No
32	Difficulty in Holding Objects in hands or Fingers	Spinner	Is Mandatory Choose: Yes No
33	Weakness in feet that cause difficulty in walking	Spinner	Is Mandatory Choose: Yes No
	Part B2: Women Only
1	Lump in the Breast	Spinner	Is Mandatory Choose: Yes No
2	Bleeding after Menopause	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Inform ASHA Facilitator."
3	Blood Stained Discharge from the Nipple	Spinner	Is Mandatory Choose: Yes No
4	Bleeding after intercourse	Spinner	Is Mandatory Choose: Yes No
	Part B3: Elderly Specific
1	Feeling unsteady while standing or walking	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "
2	Suffering from any physical disability that restrict movement	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "
3	Needing help from others to perform every day activities such as eating, getting dressed, grooming, bathing, walking, or using the toilets	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "
4	Forgetting names of yours, near ones or your own home address	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "
	Part C: Risk factor for COPD
1	Type of Fuel Used for Cooking	Spinner	Choose: Wood, Crop Residue, Gobar Gas, Coal, Kerosene oil, LPG
2	Occupational Exposure	Spinner	Choose: Crop residue burning / burning of garbage – leaves/working in industries with smoke, gas and dust exposure such as brick kilns and glass factories etc.
	Part D: PHQ2
	Over the last two weeks bothered by the following problem?
1	Little interest or pleasure in doing things?	Spinner	Choose: Not at all several days more than half the days nearly every day	Score Logic: If option selected is "Not at all" then display "0"If option selected is "several days" then display "1"If option selected is "more than half the days" then display "2"If option selected is "nearly every day" then display "3"
2	Feeling down, depressed or hopeless?	Spinner	Choose: Not at all several days more than half the days nearly every day	Score Logic: If option selected is "Not at all" then display "0"If option selected is "several days" then display "1"If option selected is "more than half the days" then display "2"If option selected is "nearly every day" then display "3"
3	Total Score	Label		Total Score formula: Sum of all the above score If "Total Score" is more than "3" then display pop up message "Refer the person to MOIC for treatment."

Communicable Diseases

Tuberculosis

Tuberculosis (TB) is a bacterial disease.
There are mainly two types of TB patients:

DS-TB (Drug-Sensitive) These are less severe case where the treatment is done for 6 months.
DR-TB (Drug-Resistant) These are less severe case where the treatment is done for 9-24 months.

Role of ASHA

The primary task of ASHA is to identify the suspected TB case and take them to nearest PHC.
In PHC LT (Lab Technician)/ STS (Senior Treatment Supervisor) checks and confirms the disease.
After confirmation the patient receives an I'd card and medicine.
ASHA fills and maintains a "Treatment card" (Annexure 1) of the patient and need to do the regular follow-ups till full recovery.

Incentive Logic:

ASHA will only receive an incentive of Rs. 500 once the TB is confirmed.
In case of DS-TB ASHA receives an incentive of Rs. 1000 after successful treatment of 3 months.
In case of DR-TB ASHA receives an incentive of Rs. 2000 after successful treatment of 6 months and after successful completion of the treatment ASHA receives Rs. 3000 extras, which makes total incentive amount as (Rs. 2000 + Rs. 3000) Rs. 5000.

TB Screening

In this section show all beneficiaries irrespective of any age group and gender.
Maintain a separate list for TB Suspected cases for further follow-ups.

S No	Early Detection of Tuberculosis (TB) Ask if Patient has any of these symptoms
	* If "Yes" is selected for any one of the questions below with "*" then show a pop-up message "Refer to MO and collect the Sputum sample". Show these beneficiaries to 'Suspected TB cases' section
	If "Yes" is selected for any one of the questions below with "" then show a pop-up message "Refer to MO or inform ANM/MPW to tracing of all family members"
1	Date	Calendar Date Picker	Is Mandatory	Default value Today's Date Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
2	Name	Textbox		Auto fill from Beneficiary details Show: First Name + Last Name Read only
3	Age	Textbox		Auto fill from Beneficiary details Read only
4	Sex	Textbox		Auto fill from Beneficiary details Read only
5	Coughing More than 2 weeks *	Spinner	Is Mandatory Choose: Yes No
6	Blood in Sputum *	Spinner	Is Mandatory Choose: Yes No
7	Fever > 2 weeks *	Spinner	Is Mandatory Choose: Yes No
8	Loss of Weight *	Spinner	Is Mandatory Choose: Yes No
9	Night Sweats *	Spinner	Is Mandatory Choose: Yes No
10	History of TB *	Spinner	Is Mandatory Choose: Yes No
11	Are you currently taking Anti TB drugs **	Spinner	Is Mandatory Choose: Yes No	Inform to ANM / MPW/ MO for tracing of Family members
12	Anyone in Family Currently Suffering from TB **	Spinner	Is Mandatory Choose: Yes No	Inform to ANM / MPW/ MO for tracing of Family members
13	Submit	Button

Suspected TB cases

Maintain a separate list of Suspected TB cases based on above assessment check.
This section should contain only Suspected TB cases

S. No	Name of data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
1	Date	Calendar Date Picker	Is Mandatory	Default value Today's Date Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
2	Name	Textbox		Auto fill from Beneficiary details Show: First Name + Last Name Read only
3	Age	Textbox		Auto fill from Beneficiary details Read only
4	Sex	Textbox		Auto fill from Beneficiary details Read only
5	Is Sputum sample collected?	Spinner	Is Mandatory Choose: Yes No
6	Sputum sample submitted at	Spinner	Choose: DMC SC PHC	Enable if "Yes" is selected for 'Is Sputum sample collected?'
7	Nikshay ID	Textbox		Enable if "Yes" is selected for 'Is Sputum sample collected?'
8	Sputum Test result	Spinner	Choose: Positive Negative	Enable if "Yes" is selected for 'Is Sputum sample collected?' If Test is positive refer to MO Show alert Message: "Refer to MO"
9	Referred to facility	Spinner	Is Mandatory Choose: Yes No
10	Facility Referral follow-ups	Textbox
11	Submit	Button

Dashboard

The landing page includes a top navigation bar with menu options:

Dashboard
Home
Work Plan (To do List)

ASHA Dashboard

It will include sections that track and display the following data:
1.Micro Birth Plan.
2.EC Registration.
3.NCD
4.HRP
5.HRNP
6.LBW
7.TB
8.Pregnant Women Registered

Micro Birth Plan				EC Registration
NCD				HRP
HRNP(suspected HRP and HRP)				LBW
TB				Pregnant Women Registered
S No	Name of the Data Field	Field Type	Value/option		Validation/ Logic/ Condition
1	Micro Birth Plan	Button	< Calendar>		Auto – Populate the Count Upon clicking, Navigate to the Beneficiary card line listing.
2	EC Registration	Text box			Auto – Populate the Count Upon clicking, Navigate to the Beneficiary card line listing.
3	NCD	Text box			Auto – Populate the Count Upon clicking, Navigate to the Beneficiary card line listing.
4	HRP	Textbox			Auto – Populate the Count Upon clicking, Navigate to the Beneficiary card line listing.
5	HRNP				Auto – Populate the Count Upon clicking, Navigate to the Beneficiary card line listing
6	Low Birth Weight Babies				Auto – Populate the Count Upon clicking, Navigate to the Beneficiary card line listing
7	TB				Auto – Populate the Count Upon clicking, Navigate to the Beneficiary card line listing
8	Pregnant Women Registered				Auto – Populate the Count Upon clicking, Navigate to the Beneficiary card line listing

ASHA Work Plan

The landing page includes a top navigation bar with menu options:
ASHA Work Plan (To do List):
This helps ASHAs plan, organize, and track their daily activities related to healthcare service delivery in their communities. The scheduler assists in ensuring timely and efficient execution of tasks, managing appointments, and maintaining records of interactions and interventions with beneficiaries.

Top Bar (light colour)

"Workplan" should be placed on the left and set as the default active view.
"Overdue Task" should be positioned on the right corner .

Increment Date Button: This button allows the user to move to the next date or previous date to view tasks for different days.
Alerts: overdue tasks to be displayed prominently in the header section.
Categories: Categories are clearly listed and clickable. Each category displays the number of tasks due, on clicking, fetch a form displaying Name, Gender, Age, Husband's Name, contact number, and Ben ID; clicking again navigates to the Beneficiary card.
Scrollable Work List: A scrollable list of tasks
Data must be saved persistently across logins using local storage or syncing with a server, and should only be lost if the ASHA uninstalls the app or uses a different app version.

Features: (Categories)

Color Coding Task: Use different colors for Task below
ANC Due Count
VHSND Due Count
Pregnant Women Immunization Due Count
Child Immunization Due Count PNC
HBNC Due Count
HBYC Due Count
EC Tracking Due Count
CBAC due list Due Count
PMSMA Due Count

Calendar <dd/mm/yy>			Overdue Task(2!)
ANC (5)			VHSND (Due date)
PW Immunization (1) current date			Child Immunization (2) 6wks to 24wks on current
HBNC Due Count			HBYC Due Count
PNC()			CBAC List Due Count(Dashboard)
Micro Birth Plan selected date			EC Tracking
PMSMA Due count ()

S No	Name of the Data Field	Field Type	Value/option	Validation/ Logic/ Condition
1	Increment Calendar Date	Button	< Calendar>	Today's Date must be displayed prominently and can be navigated by clicking "Less than" (<) and "More than" (>) buttons to show the previous and later dates, respectively and populate the respective Work plan records based on selected date
2	Overdue Tasks() (Currently On Hold)	Text box		Auto – Populate the Count Fetch the Pending records and display it on current date Upon clicking, fetch a form displaying Name, Gender, Age, Husband's Name, Contact number, and Ben ID; clicking again navigates to the Beneficiary card. Forms must be Scrollable
3	EC Tracking ()	Text box		Auto – Populate the Count Formulas: Women Due for EC = Selected Date - Last Visit Date = 30 days Upon clicking, fetch a form displaying Name, Gender, Age, Husband's Name, Contact number, and Ben ID; clicking again navigates to the Beneficiary card. Forms must be Scrollable
4	ANC () ANC1() ANC2() ANC3() ANC4()	Label		Auto – Populate the Count, ANC1, ANC2, ANC3, ANC4 must show the independent records Formulas: ANC = Sum of count of (ANC1 + ANC2 + ANC3 + ANC4+ANC5+ANC6+ANC7+ANC8). (ANC = Sum of count of all ANCs) ANC 1: List of Women due for ANC1 (Pregnant Women Registration is done) ANC 2: List of Women whose ANC 1 is done and Due for ANC 2 ANC 3: List of Women whose ANC 2 is done and due for ANC3 ANC 4: List of Women whose ANC 3 is done and and due for ANC4 Upon clicking, show the Line listing Forms must be Scrollable
	Micro Birth Plan (0)	Textbox		Auto – Populate the Count, Formulas: Micro Birth Plan Due: Calculate the due date as 2 weeks before the EDD Upon clicking, fetch a form displaying Name, Gender, Age, Husband's Name, Contact number, and Ben ID; clicking again navigates to the Beneficiary card. Forms must be Scrollable
5.	VHSND () Due date(Every Wednesday)			Auto-Populate next VHSND "Due Date" on VHSND card Calendar: Auto Populate the VHSND date, with the default set to the upcoming Wednesday, showing all activities due until that date. (Date Format- "dd/mm") Due Dates: (a)Pregnant Women due for TD Doses: 1.Td(Dose 1)- List of Pregnant Women who are Due for Td 1 between >=5 and <36 Weeks and fall on the Selected Date 2.Td(Dose 2)- List of Pregnant Women who are Due for Td 1 between >=5 and <36 Weeks and fall on the Selected Date b) Children Due for Immunization ()On Wed , Show the list children who are due for 6wks as on Wednesday to 24 months
6	PNC()	Textbox		Auto – Populate the Count, Formulas:AS on the Select day display who is due for respective PNC PNC 1: Due Date "Date of Delivery" + 1 day PNC 2:Due Date = "Date of Delivery" + 7 days PNC 3:Due Date = "Date of Delivery" + 14 days PNC 4:Due Date = "Date of Delivery" + 42 days Upon clicking, fetch a form displaying Name, Gender, Age, Husband's Name, Contact number, and Ben ID; clicking again navigates to the Beneficiary card. Forms must be Scrollable
7	PW Immunization ()	Textbox		Auto – Populate the Count, Formula: Td-1 Due Date = LMP Date + 36 weeks Td-2 Due Date = (Date of Td-1 + 4weeks) + 36 weeks Td Booster = LMP Date + 36 weeks Upon clicking, fetch a form displaying Name, Gender, Age, Husband's Name, Contact number, and Ben ID; clicking again navigates to the Beneficiary card. Forms must be Scrollable
8	Child Immunization ()	Textbox		Auto – Populate the Count, Child Immunization Due () Please refer 3.6.3 Section "Immunization schedule Date logic for Dues" Upon clicking, fetch a form displaying Name, Gender, Age, Husband's Name, Contact number, and Ben ID; clicking again navigates to the Beneficiary card. Forms must be Scrollable
9	CBAC Due Count(Dashboard)	Textbox		Auto – Populate the Count, Formula: CBAC Due Date=Date of Last Screening +365 days Upon clicking, fetch a form displaying Name, Gender, Age, Husband's Name, Contact number, and Ben ID; clicking again navigates to the Beneficiary card. Forms must be Scrollable
	PMSMA ()	Text Box		Auto – Populate the Count, Calendar: Auto Populate the PMSMA date, with the default set to the upcoming due date "9^th" of every Month The woman is in 2nd or 3rd trimester and that the visit is due on the 9th of the month Formula: PMSMA Due Date: Falls between LMP + 13 weeks (start of 2nd trimester) and LMP + 39 weeks (end of 3rd trimester).

High Risk Cases
Here Show due list of beneficiaries based on Today's date:

Show count of High Risk Pregnant Women
Show count of High Risk Babies
Show count of Low Birth Weight Babies

ASHA Incentives
Incentive Claim Form should be calculated on monthly basis, that is claim Form should be generated for every month
At any point of time should be able to generate claim Form for selected month
Should the maintain the status of claimed activity and un claimed activity for every beneficiaries
Since some of the activities start and end up after 3 months, 6 months, 9 months and 2 Years, 5 years, so we need to track this activities when it is ended, based on the end date of activity that activity amount can be claimed in that month.

Village level Forms:

Purpose:

To ensure accurate data entry for ASHA workers attending the Village Health and Nutrition Day (VHND)

Feature:

This feature enables ASHA workers to log their participation in VHND sessions. The system to ensure all mandatory fields are correctly filled before submission, preventing incomplete entries.

Incentive Logic: ASHA receives an incentive of Rs. 200 per session for successfully mobilizing beneficiaries and attending the Village Health and Nutrition Day (VHND).

Name of the Data Field	Field Type	Value/option	Validation/ Logic/ Condition
VHND Date	Date Picker	MM/YYYY	Mandatory, cannot be a future date
Place	Text Box		Mandatory, Alphanumeric + Special Characters allowed, Allow maximum 100 Characters
No. of Beneficiaries Attended	Numeric	0-999	Mandatory, Only Numeric Allowed ASHA will receive an incentive of Rs. 200 per VHND session only if the VHND Date, Place, and Number of Beneficiaries Attended are correctly filled.
Upload Image	File Upload		Allow only specified file formats allowed; file size must not exceed 5MB. JPEG, PNG, PDF (Max size: 5MB)
Submit	Button		When the Submit button is clicked, check if all mandatory fields are filled. If any field is missing, show a pop-up message: "Please fill all mandatory fields before submitting." Highlight the unfilled fields in red for user attention. Incentive logic: Upon Submit, Add ASHA incentive of Rs. 200 per VHND session for successfully mobilizing beneficiaries and attending the Village Health and Nutrition Day (VHND) as per FMR code 3.1.1.6.1

VHNC :

Purpose:

To ensure accurate data entry for ASHA workers convening and guiding the monthly Village Health, Sanitation, and Nutrition Committee (VHNC) meeting by validating required fields before allowing submission.

Description:

This feature allows ASHA workers to log their participation in VHNC meetings. The system ensures all mandatory fields are correctly filled before submission, preventing incomplete entries.

Data Field Details & Validation Logic:

Name of Data Field	Field Type	Value/Option	Validation/ Logic/ Condition
VHNC Date	Date Picker	MM/YYYY	Mandatory, cannot be a future date
Place	Text Box		Mandatory, Alphanumeric + Special Characters allowed, Allow maximum 100 Characters
No. of Participants Attended	Numeric	0-999	Mandatory, only numeric allowed
Upload Image	File Upload		Allow only specified file formats allowed; file size must not exceed 5MB. JPEG, PNG, PDF (Max size: 5MB)
Submit	Button	-	When the Submit button is clicked, check if all mandatory fields are filled. If any field is missing, show a pop-up message: "Please fill all mandatory fields before submitting." Highlight the unfilled fields in red for user attention. Incentive logic: Upon Submit, Add ASHA incentive of Rs. 150 per meeting for Convening and guiding monthly Village Health Sanitation and Nutrition meeting. as per FMR code 3.1.1.6.1

PHC Review Meeting

Purpose:

To ensure ASHA workers accurately log their attendance at PHC review meetings by validating required fields before allowing submission.

Description:

This feature records ASHA workers’ participation in PHC review meetings. The system enforces validation rules to ensure completeness before submission, preventing incomplete entries.

Data Field Details & Validation Logic:

Name of Data Field	Field Type	Value/Option	Validation/ Logic/ Condition
PHC Review Meeting Date	Date Picker	DD/MM/YYYY	Mandatory, cannot be a future date
Place	Text Box		Mandatory,Alphanumeric + Special Characters allowed max 100 characters
No. of Participants Attended	Numeric	0-999	Mandatory, only numeric allowed
Upload Image	File Upload		Mandatory, only JPEG, PNG, PDF (Max: 5MB) formats allowed, file size must not exceed 5MB
Submit	Button		- Check if all mandatory fields are filled. - If any field is missing, show a pop-up: "Please fill all mandatory fields before submitting." - Highlight unfilled fields in red.

SAKHI App Modules and flow diagram

Space shortcuts

Page tree

BRD Sakhi Mobile App

Introduction

Document Purpose

About Piramal Swasthya

Background

Background of ASHA Concept

Roles & Responsibilities of ASHA

ASHA is expected to fulfill her role through below 5 major activities in the community

About the ASHA application

Purpose

Scope of Work

Users of the system

In Scope ASHA Functional Modules

App Functionality

Household and beneficiary Registration Functionality

Lists sections and type of Lists and condition

Process of Generating Beneficiary Ids

Door-to-door Survey

System Validations

New Household Registration

Family Details

House Hold Details

House Hold Amenities

Family member Registration

Beneficiary Registration

Status of Woman

OTP Consent Mechanism

Eligible Couple Module

Eligible couple Registration

Eligible couple Tracking

Maternal Health

Pregnant Women Registration

Ante Natal care visits

PMSMA Form

Delivery Outcome

Post-Natal Care Visits of Mother

Micro Birth Plan

Infant Registration

Child Registration

HBNC: Home Based Newborn Care

HBYC: Home Based Care for Young Child

Immunization

Immunization schedule as per above Age groups

Immunization data entry screen

Immunization schedule Date logic

Immunization schedule for Pregnant Woman

Child Death Review

Maternal Death Surveillance and Response

Disease Control

Non-Communicable Diseases

Community Based Assessment Checklist (CBAC) Form

Communicable Diseases

Tuberculosis

TB Screening

Suspected TB cases

Dashboard

ASHA Dashboard

ASHA Work Plan

Village level Forms:

VHNC :

Purpose:

Description:

Data Field Details & Validation Logic:

PHC Review Meeting

Purpose:

Description:

Data Field Details & Validation Logic:

SAKHI App Modules and flow diagram