KEYAR, a second-generation e-partograph developed by JANITRI Innovations Private Limited, may significantly contribute towards increasing implementation fidelity in terms of real-time intrapartum monitoring of three parameters namely, uterine contractions (frequency and duration), maternal pulse, and Fetal Heart Rate (FHR). KEYAR is an affordable, easy to use, and portable labour monitoring device for continuous monitoring of FHR, uterine contractions (frequency and duration), and maternal pulse during intrapartum period in low resource settings. The device automatically monitors all these three parameters in real-time, feeds the data into an e-application to generate partograph, analyses the pattern, and gives colour-coded/sound alerts if foetus or mother is in distress. The analyses are easily interpretable by a low-skilled health worker. Use of KEYAR in primary healthcare settings at the last-mile in developing countries can substantially improve the quality of intrapartum fetal and maternal monitoring.

Partogram is a very important labour document and currently almost 90% of staff nurses fill it retrospectively which delays the care time and increases morbidity. Janitri Innovations have developed an application called "DAKSH" which can be downloaded on a tablet or a mobile phone that helps in generating a ePartogram which is very easy to fill and maintain the records. "KEYAR" is another path breaking innovation which is very different from conventional CTGs available currently. It is very affordable, portable and easy to use and also provides real time relay of the data with timely alerts and alarms. It is a patch based fetal heart rate, maternal heart rate and uterine contraction monitor. The patch goes on to the abdomen of the patient and the setup is really easy. It is a single time placement and helps in remote monitoring efficiently.

As per the Nanjundappa committee report, Pavagada, a remote and far to reach basic amenities like in health sector, Janitri had taken up the task of installing special instruments in all CHC. PHC, Taluk hospital where the delivery was occurring. This was of great help to all doctor, staff nurses working in these hospitals, and even in absence of doctors our staff nurses were able to identify the early danger signs of ANC and refer the patient for further follow up in higher centres. This was of great help to people of Pavagada in particular and later it was extended to other district of our state. I feel immense pleasure that I was an administrator during this pilot project. I wish good luck to Janitri, Daksh in furture days, and be expanded to whole state.