The use of real-time monitoring (RTM) to support national systems strengthening is growing, primarily due to the ubiquitous penetration of mobile phones into global audiences. According to the International Telecommunication Union, in 2011 alone, there were six billion mobile subscribers–with 79 per cent of them in the developing world (Abaza and Marschollek, 2017). This has been a boon in countries and regions where mobility and physical connectivity challenges can affect the diffusion of knowledge of key issues, which can stymie progress against key health and socioeconomic indicators. India is no stranger to RTM systems, having been one of the early adopters of mobile and digital technology in the low-and-middle-income world. It has 1.16 billion telecommunication subscribers in the world, as of March 2019 (TRAI, 2019), and has been adding nearly six million subscribers per month (TRAI, 2019). The Ministry of Health’s National Health Portal has shortlisted a whopping 72 monitoring platforms that have been authorised to track indicators from health records in hospitals to mapping water supply sources (2020).
Development programmes are actively embracing RTM approaches across a range of sectors; from maternal health to nutrition and water, sanitation and hygiene (WASH)- to improve planning, monitoring, and decision making efforts. During this COVID-19 response, it has become an even greater priority to invest in RTM models that adhere to physical distancing protocols. Caseloads are increasing rapidly with shorter doubling times and countries are scrambling every day to better understand what is influencing the outcomes as quickly as possible. Plus, given the transmission model, traditional monitoring efforts such as door-to-door assessments come with high risks for health and community workers. Real-time monitoring that allows low-touch data collection and dissemination would, therefore, be best in this context, as proven before during the Ebola and H1N1 outbreaks, both of which had similar contact restrictions.
The practice of real-time monitoring for strengthening national monitoring systems has been employed by UNICEF and government partners to strengthen health, education, water and sanitation and social protection systems around the world. As of 2019, 77 UNICEF country offices including India’s are using real-time approaches enabled by the use of information and communication technologies which enable faster retrieval and analysis of data and information, than paper-based or other traditional systems.
When using real-time approaches, data and information is provided more rapidly than before and allows stakeholders to monitor progress towards goals by rapidly accessing and reviewing data and information, seeing trends, and identifying corrective actions required based on informed evidence-based decisions within a day, or in some cases, within a few hours. Therefore, it is an efficient solution to monitoring needs and objectives. Just as important to keep in mind is that RTM approaches are only effective where the capacity to utilise frequent data and insights is sufficient and responsive; otherwise, the approach may have a negative effect of creating extra data collection burden without commensurate response.
When implemented, RTM integration helps to:
Provide a monitoring platform for communities and governments to track progress towards shared goals
Identify supply, demand and bottlenecks in service delivery chains
Increase accountability of government to the rapid delivery of services
Improve service delivery to hard to- reach communities through informing corrective measures
Assess and educate consumers and beneficiaries on relevant knowledge, practices and attitudes.