FMCH: Digitizing Nutrition for Scaling Impact
Summary
Impact Created
3x
Increase In Families Reached.
77%
Of SAM/MAM Children Moved To The Healthy Category.
21%
Drop In Missed High-risk Visits
About the organisation
FMCH is a public health NGO that focuses on improving maternal and child nutrition during the critical first 1,000 days of life. It delivers direct services and strengthens government systems through evidence-based counselling, tech-enabled tools, and community-based outreach models.
Problem Statement
FMCH faced challenges in scaling its nutrition programs while maintaining quality due to inconsistent counseling, ineffective scheduling, and fragmented data. Field officers lacked standardized tools for follow-ups and prioritizing high-risk cases like SAM/MAM, leading to missed critical interventions and limited insights into program performance.
Solution
FMCH developed NuTree, a multilingual mobile app designed to digitize and streamline field operations for frontline workers. NuTree provides structured, protocol-based counseling workflows, intelligent scheduling for high-risk cases, and real-time data entry, enhancing accountability and ensuring consistent, timely care delivery. They also created NuTree Lite for wider adoption by Anganwadi workers within government systems.
Learnings
- Structured protocols within technology enable precise prioritization and proactive care delivery.
- Real-time dashboards transform into effective mentoring and accountability tools.
- Digital inclusion is achievable for first-time users with proper support and tailored tools.
Key Technologies Used
- NuTree App (Android)
- NuTree Lite
- Microsoft Power BI
- WhatsApp Integration
- Glific Chatbot
Quick Facts
Organisation Name
Foundation for Mother and Child Health (FMCH)
Organisation Website
Visit Site
Founding Year
2006
Number of Beneficiaries served
Over 147,000 families reached in 2023–24; more than 200,000 women and children reached since inception
Geography Served
Primarily Maharashtra
Focus Area
Programmatic Impact & Capacity Development
Functions Impacted
Program Delivery / Beneficiary Services; Field Supervision
SDG Addressed
Full Case Study
Challenges
Problem Statement / Challenges Faced
FMCH operates in some of the most resource-constrained environments, where field officers serve as the critical bridge between clinical protocols and community care. However, the organisation encountered several systemic and operational challenges that limited its ability to scale impact while maintaining quality:
Inconsistent Quality of Counselling
Field officers were trained in maternal and child health protocols, but there was no system in place to ensure that every visit followed standardised steps. The absence of structured decision support meant that important clinical questions were sometimes missed, leading to variable care across households and geographies.Ineffective Scheduling and Follow-Up
There was no tool available to help workers prioritise daily visits or ensure timely follow-ups. As a result, high-risk cases especially pregnant women and children with Severe Acute Malnutrition (SAM) or Moderate Acute Malnutrition (MAM)were often delayed or missed entirely. Missed visits had direct implications for early detection and timely intervention.No Distinction in Protocols for Critical Cases
FMCH lacked dedicated workflows or alert systems for malnutrition cases. Without a specific protocol for SAM/MAM, field staff had no way to escalate urgent cases or adjust visit frequency based on severity. This delayed treatment and compromised outcomes for vulnerable children.Fragmented Data and Limited Insights
Manual data collection led to information silos, inconsistent recordkeeping, and limited visibility into program performance. Managers could not track field productivity, assess compliance with protocols, or use real-time data to make course corrections.
Together, these issues posed a significant barrier to FMCH’s mission: delivering timely, high-quality, and equitable care to every mother and child. The organisation needed a solution that not only digitised field workflows but truly enabled field workers to do their jobs better with greater precision, efficiency, and empathy.
Solution
Solution Development
To address these challenges and strengthen service delivery, FMCH developed NuTree, a multilingual mobile application designed to streamline field operations and enhance accountability. The app provided frontline workers with structured, protocol-based counselling workflows, ensuring consistent delivery of health and nutrition information across all visits. Through built-in decision trees and multimedia learning aids, NuTree empowered field officers to tailor communication to each family’s context while maintaining adherence to clinical guidelines.
The platform featured intelligent scheduling tools that prioritised high-risk cases and helped reduce missed visits. Real-time data entry and synchronisation enabled supervisors to monitor progress, review performance, and provide timely support. In addition to its core features, FMCH introduced NuTree Lite, a simplified version tailored for Anganwadi workers, encouraging wider adoption within government systems.
By integrating technology with field-based knowledge, NuTree became a cornerstone of FMCH’s approach to scalable, high-fidelity public health programming.
Solution Roll-Out Approach
FMCH rolled out its digital solution in phased releases, each focused-on building functionality while reinforcing field usability and program integrity.
The initial version introduced registration and decision-tree-based counselling protocols. It was piloted with a small group of field officers, with user feedback and UAT guiding refinements before wider adoption.
This release added structured workflows for high-risk malnutrition cases and integrated Power BI dashboards for supervisory insights. Revisions were based on field feedback to ensure real-time data use translated into timely interventions.
A simplified version was co-developed with ICDS departments to suit public system needs. Tailored for ease of use in low-resource settings, NuTree Lite enabled scale while retaining core functionalities.
At each stage, features were tested, observed, and refined in real conditions. Field teams were actively engaged in shaping functionality, ensuring that each release aligned with actual workflows and capacity. FMCH’s approach demonstrated that digital success lies in listening, iterating, and building with and not just for users.
Tech Stack
| Component | Description |
|---|---|
| NuTree App (Android) | Protocol-based workflows, multilingual user interface, and visit tracking |
| NuTree Lite | Simplified version designed for Anganwadi workers |
| Microsoft Power BI | Dashboarding and analytics for field-level and program-level decision-making |
| WhatsApp Integration | Video content sharing and behavioral nudges for community engagement |
| Glific Chatbot | AI-driven, rule-based conversational agent designed to support mother engagement |
Key Project Learnings
FMCH’s experience with NuTree highlighted how thoughtfully integrated technology can enhance frontline efficiency, accountability, and sustainability of outcomes:
- Structured Protocols Enable Prioritisation: Integrating SAM and MAM guidelines into scheduling allowed field teams to deliver more timely and proactive care.
- Dashboards Strengthen Daily Practice: Real-time visual tools evolved into mentoring aids, driving accountability and informed supervision.
- Digital Inclusion is Achievable: With the right support, even first-time users like Anganwadi workers adopted digital tools with confidence.
- Peer-Led Support Sustains Change: The mother support group pilot demonstrated that community-driven, tech-enabled models can continue to deliver impact beyond NGO involvement.
- Shift from Outputs to Outcomes: Composite indicators helped move beyond activity tracking to enable decisions based on real outcomes.
Adaptability In the Sector
NuTree’s flexible design and field-tested success make it well-suited for replication across the development ecosystem:
- Government Systems Platforms like ICDS, NHM, and POSHAN can integrate similar tools to strengthen frontline delivery and supervision.
- NGO Field Operations Organisations can adopt NuTree’s approach to digitise field processes while maintaining a people-first approach.
- Collaborative Projects Ideal for multi-partner initiatives requiring shared dashboards, unified data standards, and aligned reporting.
NuTree has not only scaled FMCH’s impact but also offers a replicable blueprint for tech-enabled, community-driven delivery at scale.
Outcomes & Impact
NuTree significantly enhanced FMCH’s ability to scale nutrition care while improving frontline performance and outcomes for children.
- Expanded Reach: 3× increase in families reached; from 7,100 families in 2020–21 to 147,405 families in 2023–24.
- Improved Health Outcomes: 77% of SAM/MAM children (Severe/Moderate Acute Malnutrition) moved to the healthy category.
- Better Targeting and Timeliness: Missed high-risk visits dropped from 58 percent to 37 percent, enabling more timely care.
- Smarter Decisions: Real-time dashboards supported faster identification of cases and improved field supervision.
- Greater Accountability: Field teams showed stronger adherence to protocols, leading to a culture of data-driven action.
