ANMOL (ANM Online) — Odisha

What is ANMOL in Odisha?

ANMOL, an acronym for "ANM Online" — is an Android application used by Auxiliary Nurse Midwives (ANMs) in Odisha to record the services they deliver, at the moment they deliver them. It is run by the Health and Family Welfare Department, Government of Odisha through National Health Mission, Odisha, and it sits inside the department's e-swasthya group of digital initiatives alongside the Odisha e-Hospital Management Information System, the Niramaya drug-tracking software, the e-Blood Bank and the Health Management Information System.

The Health and Family Welfare Department's Annual Activity Report 2020-21 describes ANMOL as "an android based application, developed to facilitate smoothly work of ANMs as well as ensuring collection of good quality data and its digitization at its source", and records that it "has been implemented in all 30 districts". The 2022-23 report adds that the RCH portal, which ANMOL feeds, "has been implemented in all districts since 2016", and that "ANMs trained in ANMOL are updating the services in the application using tablets provided to them by the State".

The single most important thing to understand about ANMOL: it is not a benefit scheme. It is a work tool for government health workers. Some scheme listings describe "Anmol Yojana" as an urban health scheme offering outpatient and diagnostic services to city residents. That description does not match what the Government of Odisha actually operates. The urban outpatient specialist programme in Odisha is Ama Clinic; free diagnostics are provided under Nidaan; free essential drugs under Niramaya; free dialysis under Sahay; and hospital treatment cover under Gopabandhu Jan Arogya Yojana. ANMOL is the digital record-keeping layer, and no citizen applies for it.

Where did ANMOL come from?

Chief Minister Naveen Patnaik announced ANMOL on 19 December 2017 at a Secretariat event that launched four health initiatives together, Nidaan for free diagnostic services in public health facilities, Sahay for free dialysis, Ama Clinic for specialist consultations in urban clinics, and ANMOL, under which tablet computers were distributed to ANMs to improve real-time service delivery, with a primary focus on maternal and newborn healthcare. Most of the services became operational from 1 January 2018.

The application did not appear in a vacuum. Odisha had already implemented the central RCH portal in all districts from 2016 to monitor the provisioning of maternal and child care services. ANMOL is the field-level data-entry front end for that system: instead of an ANM filling a paper register at a sub-centre and someone later keying it into a computer, the ANM enters it directly on a tablet at the point of care.

What does the ANM actually record in ANMOL?

The Health and Family Welfare Department's reports identify two distinct record streams on the ANM's State-supplied tablet:

• Reproductive and child health records. ANMOL allows the ANM to enter and update the service records of eligible couples, pregnant women and children under the RCH programme. This is the antenatal check-up, delivery, postnatal and immunisation history that the district and state monitor.
• Non-communicable disease records. The Annual Activity Report notes that the "NCD App application is also loaded in the ANM tablet for recording the enrolment and screening details by ANMs". Odisha's population-based screening programme has screened more than 14 lakh people above 30 years of age, and the enrolment and screening entries for that work are made on the same device.

The data flows upward into the RCH portal and, for facility-level monthly service data, into the Health Management Information System on the central IHIP platform, which since April 2020 has captured data from across 8,527 public institutions in Odisha and more than 500 private health facilities.

Who is covered by ANMOL?

Whose records go into ANMOL:

• Eligible couples registered by the ANM in her sub-centre area.
• Pregnant women, from antenatal registration through delivery and the postnatal period.
• Children, principally for immunisation and growth-related contacts.
• Adults aged 30 and above screened for non-communicable diseases, through the NCD application on the same tablet.

Who cannot apply for ANMOL:

• No citizen can apply. There is no ANMOL application form, no eligibility certificate, no beneficiary list to get your name onto and no cash entitlement attached to it. You are not eligible or ineligible for ANMOL; you are simply recorded in it, or not recorded in it, depending on whether you have had a contact with an ANM.
• Private practitioners and private hospitals do not use it. ANMOL is issued to government ANMs and multi-purpose health workers on State-supplied tablets. If you receive antenatal care only in the private sector, your record will not appear in ANMOL unless the government ANM separately registers you.
• Anyone asking you to pay a fee to "register for ANMOL" is not describing a government process. No fee, agent or middleman exists in this system.

How to apply for ANMOL, and how to get your services recorded

Because there is no citizen-facing application, the practical question is how to get your contacts entered correctly.

1. Register your pregnancy with the ANM early. Go to your sub-centre, Health and Wellness Centre, or the Village Health and Nutrition Day or Urban Health and Nutrition Day session in your area, and register at the first antenatal contact rather than late in the pregnancy.
2. Give a working mobile number. Follow-up and due-date reminders depend on the phone number attached to your record. If the number changes, tell the ANM.
3. Carry your Mother and Child Protection card to every visit. The MCP card is the paper counterpart of the ANMOL entry. Check after each visit that the card has been filled in, and that the ANM has made the entry on the tablet.
4. Attend the notified session days. ANMs make most entries during scheduled outreach sessions, so attending on the notified day is the surest way to have a contact recorded.
5. Ask for your record if you move. If you shift to another block, district or state during pregnancy, ask your ANM for your details and MCP card so the receiving ANM can register you without gaps.
6. Get screened for NCDs if you are 30 or above. The same ANM and the same tablet handle NCD enrolment and screening under the population-based screening programme.

What ANMOL does not do

ANMOL pays no money. Maternity benefit payments in Odisha come from the state's Mamata scheme and the central Pradhan Mantri Matru Vandana Yojana; transport reimbursement for institutional delivery in notified difficult villages comes under SAMMPurNA, at Rs 1,000 per pregnant woman; free medicines come from Niramaya and free tests from Nidaan. ANMOL supports those programmes by holding accurate service records, but it is not itself a payment channel and it confers no entitlement of its own.

ANMOL also does not replace your paper card. The MCP card remains the document you carry, and it is the only copy of the record you personally hold, since there is no public citizen login to ANMOL.

Grievance route

If your antenatal, immunisation or screening contacts are not being recorded, or your ANM does not have a working tablet, raise it in this order:

1. The ANM or the Health and Wellness Centre / sub-centre in-charge.
2. The Medical Officer in charge of the Primary Health Centre or Urban Primary Health Centre your sub-centre reports to.
3. The Chief District Medical and Public Health Officer of your district.
4. National Health Mission, Odisha, where the Additional Director (Administration) is the designated nodal officer for complaint and grievance handling. The mission directorate is at the Annex Building of SIHFW, Unit-8, Nayapalli, Bhubaneswar 751012, telephone 0674-2392480, email nrhmorissa@nic.in.

The Health and Family Welfare Department can be reached at Lok Seva Bhawan, Lok Seva Marg, Unit-5, Bhubaneswar 751001, telephone 91-674-2395235, email orhealth@od.gov.in. Written grievances can also be lodged on the Odisha government's Jana Sunani portal.