[HS Conversations] Meet the Indian doctor featured in Fortune’s World’s 50 Greatest Leaders list for 2021

Dr Aparna Hegde, an internationally renowned urogynecologist and researcher, is the Founder and Chairperson of NGO ARMMAN (Advancing Reduction in Mortality and Morbidity of Mothers, Children, and Neonates). 

These are two worlds she seems to seamlessly traverse with an overlap that focuses on both healthcare and healthtech.

As the world grapples with the devastation caused by COVID-19, ARMMAN, under Dr Aparna’s leadership, undertook some key initiatives to put the health of women and children first. 

This effort led Dr Aparna to feature in the prestigious 2021 list of Fortune’s World’s 50 Greatest Leaders.

She is ranked #15 on the list, which features men and women from across the globe from the fields of business, government, philanthropy, and the arts, who are "transforming the world and inspiring others to do the same".

“I am humbled by the fact that this honour brings attention to ARMMAN’s work and the issue of maternal-child health. It brings an international focus to how pregnant women, mothers, and children deserve better lives,” she tells HerStory.

The story began when Dr Aparna was doing her residency in Mumbai’s Sion Hospital, where she was first a resident and then a lecturer.

“I saw very closely how pervasive systemic problems led to the loss of the lives of mothers and children, which is completely preventable,” she says, adding, “ARMMAN was started when I was completing my medical training in the US.”

The doctor realised very early on that if she wanted to impact lives, she needed to go into the community and start at the grassroots level. 

“We needed to make sure that problems were taken care of much earlier, and people do not come in too late. Our goal is to bring about a reduction in maternal-child mortality and morbidity,” she adds.

With the penetration of smartphones into rural India, ARMMAN initiated several technology-based programmes to reach underserved communities.

Tech for good health

The non-profit, in partnership with the government, is implementing the largest mobile-based maternal messaging programme and the largest mobile-based training programme for health workers in the world.

ARMAAN’s programmes have reached over 24 million women and children and trained more than 170,000 frontline health workers across 17 states. 

Dr Aparna explains how it works. She says, “Our vision is to empower every woman and strive to make every child healthy by leveraging technology to create scalable solutions, which are cost-effective to impact both healthcare-seeking practices and improve healthcare access.”

mMitra is a free mobile voice call service by ARMMAN that sends timed and targeted preventive care information weekly or bi-weekly directly to the phones of enrolled women through pregnancy and infancy in their chosen language and timeslot.

This, Dr Aparna says, handholds women through any queries or problems they may have. On the other hand, it also runs a mobile academy programme — a reproductive maternal, neonatal, and child training course designed to train ASHA workers’ knowledge of life-saving preventative health behaviour and improve the quality of their engagement with new and expecting mothers and their families. 

The programme uses IVR technology, which is handset-independent, audio-based, and can be accessed by a simple voice call. The course covers 33 months — from pregnancy until the child is two years of age. 

 “We are doing a very comprehensive programme in Telangana, where we are not only creating protocols for each cadre level but also training them. Training via Zoom is given to super specialists, medical officers, and auxiliary nurse-midwives. We will soon have a learning app with multimedia content with videos and interactive quizzes,” she says.

She adds it’s a combination of tech and touch that has yielded favourable results. In a random customised cluster trial, supported by UKAID in rural Maharashtra, the NGO found that when women are informed, they not only pay attention, there’s knowledge recall, and in turn, behavioural change, leading to healthier outcomes. 

In fact, there was almost a 20 percent increase in the number of infants who tripled their birth weight at the end of one year as opposed to women who didn’t get access to the services.  

Challenges amidst the pandemic

With the COVID-19 pandemic stretching healthcare systems to the limit, ARMMAN continued to leverage existing infrastructure and collaborated with the government and about 40 NGOs on-ground to reach women in underserved areas.

“When hospitals became COVID care centres, out of reach of pregnant women and new mothers, or their areas of stay became containment zones, our programmes helped them a lot. We had a virtual clinic run by doctors who would take around 200 calls a day. Our network of health workers, too, helped in disseminating the right information to women in rural India,” she says.

ARMMAN reached out to around 300,000 pregnant women and mothers and provided logistic support to over 67,000 women during this period on where to go for an ultrasound, how to get an ambulance and information on working hospitals. 

During this period, Dr Aparna also helped set up a COVID-ward at Mumbai’s Cama Hospital, a designated maternal and child hospital serving underprivileged women and children. 

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Healthcare first

As a full-time practising urogynecologist, researcher, and founder of ARMMAN, Dr Aparna’s days are full. Her outlook centres around science, service, and research.

“For me, urogynecology treats what ARMMAN tries to prevent. So one feeds off the other,” she says.

She starts her day at 4.30 am, and after some exercise, she continues with her research, reading, or strategy for ARMMAN. She also provides her services at Cama Hospital for free, takes meetings in between, and goes to her private practice in the afternoon. The evenings are again filled with meetings, and her day ends by 11 pm.

Dr Aparna also believes we should all have anticipated the second wave.

“It was obvious that minute India opened up, it was going to come back. We also had the knowledge about other countries going through different waves, and we didn’t plan for it,” she says. 

She advocates getting vaccinations earlier and advises people not to succumb to myths surrounding it.

In the future, she is looking at building in-depth programmes with ARMMAN and hopes that 15 million women get access to relevant and timely information every year.