HealthcareUser Engagement

FMCH: Digitising Nutrition for Scalable Impact

How FMCH digitized frontline health workflows using mobile-based systems and dashboards to enable real-time tracking, improve service delivery, and scale maternal and child health intervention

3x
3x
Increase In Families Reached.
77%
77%
Of SAM/MAM Children Moved To The Healthy Category.
21%
21%
Drop In Missed High-risk Visits
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Watch the story in 60 seconds (AI-generated video; visuals are illustrative)

Case at a Glance

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 programmes while maintaining quality due to inconsistent counselling, ineffective scheduling, and fragmented data. Field officers lacked standardised tools for follow-ups and prioritising high-risk cases like SAM/MAM, leading to missed critical interventions and limited insights into programme performance.

Solution

FMCH developed NuTree, a multilingual mobile app designed to digitise and streamline field operations for frontline workers. NuTree provides structured, protocol-based counselling 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.

Read the full case study
Challenge

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 & 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 record-keeping, and limited visibility into programme 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

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.

NuTree solution rollout and features

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.

Phase 1 NuTree V1
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.
Phase 2 SAM/MAM Protocols and Dashboards
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.
Phase 3 NuTree Lite for Anganwadi Workers
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.

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 & 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.
3 NuTree Lite for Anganwadi Workers

Technology Stack

Component Where it was used What it enabled Type
NuTree App (Android) Protocol-based workflows, multilingual interface, visit tracking Standardized service delivery and real-time monitoring of frontline activities Proprietary
NuTree Lite Simplified app for Anganwadi workers Increased adoption among low-tech users and expanded field coverage Proprietary
Microsoft Power BI Dashboarding and analytics Data-driven decision-making at field and program levels Commercial
WhatsApp Integration Sharing videos and behavioral nudges with communities Improved engagement and behavior change among beneficiaries Commercial
Glific AI-driven conversational chatbot for mothers Scalable, personalized engagement and support for beneficiaries Open-source

Key Project Learnings

FMCH’s experience with NuTree highlighted how thoughtfully integrated technology can enhance frontline efficiency, accountability, and sustainability of outcomes:

01
Structured Protocols Enable Prioritisation

Integrating SAM and MAM guidelines into scheduling allowed field teams to deliver more timely and proactive care.

02
Dashboards Strengthen Daily Practice

Real-time visual tools evolved into mentoring aids, driving accountability and informed supervision.

03
Digital Inclusion is Achievable

With the right support, even first-time users like Anganwadi workers adopted digital tools with confidence.

Potential for Wider Adoption

NuTree’s flexible design and field-tested success make it well-suited for replication across the development ecosystem:

Sector / Domain How this solution adapts
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.

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