Lifestyle, Tech, Travel

What Causes High Prevalence of Anemia in Rural Hinterland- A case study to assess the gap


Anemia is most prevalent in low-resource settings, where it goes undetected until becomes severe. Despite the implementation of several initiatives by the Government, India has made only 13 percent progress in eradicating anemia (Global Nutrition Report, 2017).1

Periodic screening and early diagnosis are the keys to controlling anemia. The conventional Hb tests involve invasive methods with the requirement of hygienic infrastructure and skilled healthcare providers. But with the huge gap in basic health infrastructure, rural community members have very little provision for diagnostic facilities.

In Kenduapal Village of PaschimMedinipur, West Bengal shows 88 percent of reproductive-age women have undergone Hb tests for the first time in their lives. They were not aware, if they are prone to a high-risk pregnancy or not. It also indicates the behavioral risk factor which contributes to delay in Anemia detection.

According to WHO recommendation, a non-invasive hemoglobin device is proved to be a good addition. Non-invasive point of care devices can eliminate the potential contamination, bio-hazard handling and can even enable frontline health workers with basic education to perform Hb Test.2 Joseph et al. (2016) also affirm that non-invasive methods are safer than invasive methods and improve patient satisfaction.3Bandyopadhyay S., Neogi, and John D. et al. (2019) further contributed to the fact that as most of the anaemia screening happen in outreach settings, where provision for laboratory support seems difficult, the device ought to be tested in field settings with health workers, non-invasive diagnostic provides viable accuracy.4

iKure’s non-invasive anemia screening initiative started with the vision of reaching out to the last mile community. Members are chosen from the community and are technologically and clinically trained to use them for screening patients. The community health workers are further mobilized to collect other health parameters important to understand the risk of the patients. Instead of using a paper-based format, CHWs use WHIMS that is able to collect patients’ vitals on a cloud server. The data available on the cloud are further sent to medical professionals for referral and counseling.

However, while iron deficiency is the main cause, micronutrient deficiency, inflammations and inherited disorders also contribute to anemia. A baseline report of mother and child health camps reveals that 64% of pregnant women were anemic and 30% with milder anemia. Nutritional experts suggested that a large section of the community are found to be anemic because of women’s ‘‘non-compliance/non-adherence” to the consequences of the anemia and fear and anxiety towards invasive blood drawing.5 Also, women’s consumption rate of IFA supplements are low since they complain of suffering from gastrointestinal upset. Altering such behavior requires regular counselling. iKure’s CHWs are deployed to spread awareness and bring positive health-seeking behavior among pregnant women, new mothers, and adolescent girls.

iKure’s non-invasive anemia testing initiative has been rolled out successfully in school health program and mother and child health camps catchment areas. Within few months, it has gained significant traction such as:


  • In West Bengal and Karnataka more than 50% population are found to improve IFA tablets consumption rate.
  • Regular awareness and counseling by iKure medical team during health camps have altered care-seeking behaviour with a reduced percentage of anemic patients
  • The introduction of non-invasive screening devices has improved patients’

    footfall with more women willing for Hb tests

While priorities and approaches may differ according to geographic settings, but strategies to curb anemia remain the same. At iKure, we believe in bringing the desired change soon in India’s rural villages.

Reference :

1. “From promise to impact ending malnutrition by 2030”,Global Nutrition Report,2017,
2. Ma’ayan L., Choppe L., Tikva P., Israel, Lausanne, “Non-Invasive Hemoglobin Screening for Diagnosis and Monitoring of Anemia”, Read More
3. Josheph, Bella., Haider, Ansab., Rhee, Peter., “Non-invasive hemoglobin monitoring”, International Journal of Surgery, 33 (2016):254-257
4. Neogi SB, John D, Sharma J et al. Cost-effectiveness of invasive devices versus non-invasive devices for screening of anemia in field settings in India: A study protocol [version 1; peer review: 1 not approved] F1000Research 2019, 8:861 Read More
5. “Nutritional Anaemias: Tools for Effective Prevention and Control”, World Health Organization, 2017, Read More

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Tech, Travel, Uncategorized

Population Scale Impact Through Societal Platform Lens

iKure’s journey started in 2010 to address the inadequate and inaccessible primary healthcare for the last mile using technology. We have impacted 12 M population across 8 states in India. We have the data capability powered by AI and machine learning algorithm for actionable research interventions and many more. With a full proof model, we began at a small scale. But soon, we learnt the limitation of the model that could reach only a fraction of the population when the problem was common for 70% of the India’s rural villages.

We wondered, can iKure solve the problem individually? Can we create doctors overnight or build infrastructure to solve the problem at scale? The answer was no. The problem is dynamic and multivariant in nature. On one hand, we have primary health centres that remains ineffective and less utilized due to the shortage of staff, resources and quality care and on the other hand, India with a vast population of 1.3 billion needs to build 200,000 health and wellness centres to address the demand and supply gap. In this context, iKure with 200 centres was insignificant to match up to the need.

Societal Platform thinking was important for us to reflect that technology can be the key enabler to scale, but it cannot bring different actors co-create solution together and amplify at a population scale. iKure aimed to build a shared infrastructure for multiple actors to come together to solve the common goal. We wanted to create such infrastructure, where people can access the health system with hope and newer possibilitiesThe Naga telehealth was an effort to introduce the platform thinking of co-creating together with the Government, technology partners, research partners, NGOs and grassroot members. The system opened access to healthcare, prevention and wellness for the entire state of Nagaland leveraging 192 sub health centres and 19 primary health centres.

The prototype model is adapted in Khunti District, Jharkhand with JICA to transform the ineffective health system into a dynamic one. It is serving the district hospitals, community sub-centres, and primary health centres. This has set an example for other state governments to follow, where we are partnering with 5 State governments to leverage the shared digital infrastructure for greater utilization and access to health and wellness centres and promote prevention and awareness at the community level through frontline health workers. The platform is also available in hybrid model to drive rapid adaption and evolution in local context using physical health workforce presence at patient’s door-steps. The shared digital infrastructure has co-created network of engagement at different levels. It has enabled remote health monitoring services through NGOs and self-help groups and addressing the behavioural and cultural barriers that cause vaccine hesitancies in rural villages through frontline health workers. It will bring 200,000 frontline health workers using the shared infrastructure at a mass level. In all these cases, the architecture design needs to foster trust and ownership. Use of AI model can only find relevance, if the platform ensures data privacy for all the actors in the ecosystem. Towards this, iKure is working with ODI-Microsoft to develop an automated open data platform ensuring right data reaches to right hands. A shared and collective understanding of different stakeholders can solve the problem of healthcare in totality. Through our shared infrastructure, we aim to reach out to our beneficiaries irrespective of where they are.  iKure through SP lens believes the power of shared infrastructure can amplify its potential to serve at a population scale.

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Staff Picks, Travel

The untold story of iKure beyond the narrow trails


We were at the first mile in the last mile. Our car driver whom we lovingly called Nattu was in high spirits praising the new road which has recently found a new shape after the smoothen pitch. Soon his sunlit smile faded when the road started getting narrow after taking first few turns from the NH6  Highway. The journey continued, and my heart sank, more we drove in. The road was getting narrower and almost disappearing now and then. However, the golden wheat fields, field laden with marigold flowers, and the untamed river that followed us assured me of the hope that there is a way beyond. I was led by two team members who drove the motorbike, carefree but determined of the road ahead and the founder of the ‘Unicorn’, acknowledged as the ‘100 most Influential Leader 2020’ continuing his untiring efforts of handling the venture’s responsibilities over the phone, while I waited impatiently for the journey to get over through the narrow trails.

Finally, the stop arrived at a primary school in an unknown little village in Gologram in West Bengal. iKure’s mobile medical team was already in full gear attending the patients that have gathered for the eye and medical check-up. Two Doctors, with a Paramedicine staff, Health Worker, and Program in- Charge were busy registering patient’s vitals using AI enabled health tech devices.

Locational factors have an important bearing on the potential of healthcare supplies. In urban poor and remote locations, it is difficult for healthcare systems to attain the demands of critical services. Most of the journeys made by our beneficiaries are at substantial risk of fatal outcomes during emergency cases. Therefore for iKure, it is important to provide access to primary healthcare facilities through mobile medical teams that are usually set up in schools or in local administrative offices.

The pandemic in India is witnessing its second wave, people are creeping out of their shelters, still hesitant to explore beyond their safe zone, but this medical team has a message for all of us. Inspiring as they accept risk as part of their chosen job roles, hardly exhibiting concerns on their routine door-step schedule, at iKure’s medical camps and in hubs. The immense accreditations and support to fulfill the mission of iKure ‘Creating zero mortality in primary healthcare’ through their hands and the unwavering determination of their hearts is enough to bring smiles to our beneficiaries during the challenging times of the COVID-19.

Primary healthcare is the first line of defense to keep people safe. The primary healthcare system has the capacity to diagnose, track, and contain community outbreaks while providing essential services.

iKure is prioritizing its regular services through technology innovations, mass screening operations, and research interventions that use primary data to help identify and address the gaps and laying a strong foundation for primary healthcare to protect people from the next health threats.

iKure has treated more than a million patients with plans to open 200 clinics in the next three to four years. It is already offering health-tech solutions in Vietnam with plans to serve in other South-east Asian countries like Cambodia, Philippines, and Indonesia.

The journey way back home was different. I found Nattu’s face lit up again while he shared one of his journeys with the iKure’s medical team in Keshiary, in remote West Bengal. He recalled, he had to carry back home the team through a bamboo bridge that was half immersed due to the flood. Fearing the car might not find its way underneath the water, they waited till 2:00 am for the water to subside. And finally, when they returned, it was time again for another journey.

It might come across for many that Ratan Tata’s investment has been easy for iKure. But the immense trade-off, patience, and teamwork go without saying, they haven’t had it all yet. While the team is gearing up to scale-up and expand its operations, this investment is a huge encouragement for iKure as they believe, iKure’s services will make the real difference for the people who need it most, as access to primary healthcare will be the corner stone to confront the pandemic and the situation beyond it.

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Dedicated to all the women who shaped and defined iKure

Dr. Tirumala Santra Mandal, Sr. Research & Communication Analyst, iKure brings forefront her experience in working with the other women of iKure who with her contributed and defined the venture’s entrepreneurial journey, carved new beginnings supported through women power and sisterhood- a must have for every startup culture. Read on… image iKure’s journey over several years has been shaped by countless hands. And few among them are the fearless, prominent, and prolific women, who championed new initiatives at iKure, took away our doubts, stood by us and ushered hope – with support and smile. On International Women’s Day, I take this opportunity to thank them all with immense gratitude.…. I remember the old adage, “A strong women stand for herself, a stronger woman stands for everybody else.” The narrative tells us that over the years, women have transformed and supported other women to rise up and above the rest. At iKure I have had the privilege to experience the participation of such women who stood and supported our journey both externally and internally paving way for success, flourish and thrive. Satoko Kono, Arun LLC, President-Her association with iKure started as an investor from Japan. Her calm and vibrant nature has always amazed me. She is extremely polite, naïve and takes a keen interest in our activities, success, even failure, and impact. Her eye for detail, down-to-earth attitude, and her infectious energy is something that my team always admires whenever she visits them in the field. Shreyshi Dey & Sharmistha Roy, University Of Michigan-They joined us back as VP in Research iKure. Though for a brief period of time, I recall their contribution particularly for bringing up the new iKure logo. I remember, the entire team debated around it, but they were quick and prompt to understand that what we wanted was something that can resonate with the community and reflect our motto. Kudos to them to get it just right! Mallika Rani. Das, CHW Tabageria- One year back, I met her in our Tabageria Hub. Draped in green saree, the uniform she adorns was sited among other CHWs who were getting ready to start their day’s job with door-step visits. I asked her, can you tell me what exactly you say when you visit our beneficiaries. In the next minute, the way she introduced us with a brief narrative of iKure’s mission left me amazed. While few of her fellow mates have left, but she remained with us, sure of the journey that brought her more value and respect than anywhere else. Today she handles new devices, screens patients and counsels women like a PRO. Way to go! image Gayatri S. Achari, Project Assistant-I am inspired by her continued faith and dedication towards her job. She has been a valuable member of iKure’s initiatives in Karnataka. She would often tell me, how she has become an inspiration for her family. Many pregnant women in her community preferred consulting her rather than a doctor. She told me, how working for iKure has helped her gain such respect for herself. I learned from her, it is important to love what you do, rather how you do. It adds value to work in many ways. Shwethnisha Bose,Parswati Das, Ritika Singha Roy, Riya Das, & Debleena Ganguli, Kanika Das, Technology, Operations, Research developer – The current women brigade of iKure are known for multitasking, promptness, emphatic and carrying never- say-no attitude towards their deliverables. During my daily course of interactions with them, I found them immensely passionate, braving all-odds at personal fronts and making new narratives of women co-working, co-learning and supporting each other which very few workplaces can even boost. They are responsible for bringing customized technology solutions across borders, operational acumen, in-depth impact reports, and excellent designing skills. You guys rock! image Avanti Gomes, Trainee at iKure- The young women from the University of Technology, Sydney proved that you should never undermine the young minds, making us believe once again, good things come in small packages. Her insights and deep understanding of iKure’s operations were well researched and thoroughly studied. She left behind the thought that there is lot more to women self than meets the eye. Jayanti Santra, My Mother- She is a homemaker, but a cheerleader for iKure. She raised both of her children with a wider perspective in life. Both our parents have been always supportive of our decisions and taught us to value others, be courageous and self-reliant. Her immense belief and faith in me helped me overcome my self-doubt whenever I felt low & timid. Sarah Santra, My sister-in-law- This narrative would be incomplete without mentioning her about her support towards iKure. While her husband, the CEO travelled extensively, she managed the home front with Élan, and we all know, it is no less than managing an empire. I admire her playing a pivotal role in beautifying the office ambiance with her intricate designing and styling sense which goes without saying is much valued for. She helped me understand the bigger picture of life and admiring the fact that we stand for each other when needed. More power to sisterhood. image iKure has been led by many other peers, trainees, partners whom I could not mention here due to word limits, but they are truly our cheerleaders, importantly helping us become one of the very few start-ups acquire immense acceptance and global recognition within a short span of time. We value each one of- you and look forward to having onboard more women power to inspire and support us ahead! Dr. Tirumala Santra Mandal, Sr. Research & Communication Analyst
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