Field health system · Nepal & India
LekhaSathi helps FCHVs record patient visits, track pregnancies, manage vaccination schedules, and access maternal health protocols through simple voice conversations, even without internet access.
A health worker speaks; the record writes itself. Pregnancy stage, follow-up dates, and child immunisation are tracked automatically, fully offline.
The Problem
Over 52,000 FCHVs in Nepal are the first point of contact for rural maternal and child health. They work without digital records, without follow-up systems, and without a structured way to hand patients to the next level of care.Source: PMC / NCBI, published FCHV study, 2019
No reliable record of a mother or child's history across visits. Everything depends on paper registers and personal memory.
FCHVs across Nepal
Source: PMC / NCBI, published FCHV study, 2019
Pregnant women miss antenatal visits. Children miss vaccination schedules. There is no automated tracking or reminder system at field level.
SDG maternal health target
Source: WHO Nepal, April 2025
Danger signs detected too late. No structured decision support for field workers in the critical early window.
Maternal mortality rate, Nepal
Source: WHO modelled estimate, 2023
No structured handoff between village and health facility. Patients arrive at hospitals without history. Care starts from zero.
Neonatal mortality rate, Nepal
Source: WHO 2025 / NDHS 2022
The human cost
These are not edge cases. In Nepal's Far-Western hills, mothers still deliver on the road to the health post. The gap is not awareness; it is a missing thread of tracking, risk-recognition and coordinated referral.
A woman gives birth before reaching the health post in a remote ward of Kailali district, Far-Western Nepal.
→ When history and risk do not travel with the mother, the journey to care begins too late.
Source: Reported in Nepali press (Khabarhub, eBigul)
A pregnant woman rests on the roadside while walking toward a health post in Far-Western Nepal, a practice locally called “Jatkal Basnu.”
→ Distance and the absence of a tracked, coordinated handoff turn routine delivery into emergency.
Source: Reported in Nepali press, Far-Western Nepal
All figures are sourced from published data: Nepal DHS 2022 (Ministry of Health and Population), WHO Nepal country data (April 2025), and peer-reviewed FCHV research. Field photographs are drawn from Nepali press reporting on maternal health access in Far-Western Nepal.
The Insight
Data exists in paper registers, in memory, in scattered notes and health cards. But nothing follows the patient across time, across visits, across providers. Every new encounter starts from zero.
LekhaSathi is built to fix the continuity gap, not to add another form to fill in.
Today: fragmented
With LekhaSathi: continuous
Today: fragmented
With LekhaSathi: continuous
The Three Delays Model · Thaddeus & Maine, 1994
Delay 1
Continuous tracking + danger-sign recognition surface risk early.
Delay 2
Coordinated, structured referral shortens the path to care.
Delay 3
The patient's history arrives with her, so care doesn't start from zero.
The Product
Voice-based record captured during the home visit, works fully offline.
Full patient history, pregnancy stage, and child immunisation in one view.
Next ANC visit date, upcoming vaccinations, and overdue follow-ups surfaced automatically.
Danger signs explained clearly with a direct action step: what to do, right now.
A structured printable slip the patient carries, so her history travels with her.
Every step is designed for low-literacy users, intermittent connectivity, and the real conditions of a home visit, not an office.
Field Reality
We are building LekhaSathi with frontline health workers. We are currently running discovery interviews with FCHVs and rural health post staff to ensure the system reflects how they actually work, not how we imagine they work.
This section will be updated with direct, consented accounts from field visits as they happen. No quotes appear here until we have real ones.
The Team
We are building LekhaSathi because the problem is structural, not technical, and solving it requires both.
Field Research & Clinical Workflow Translation
Platform Architecture & Offline AI Systems
Community Outreach & Pilot Operations
Presented & vetted
The idea behind LekhaSathi was presented at the 4th National Telemedicine & 1st Digital Health Conference (TMSoN) in January 2026.
The Vision
Voice record capture, pregnancy tracking, and immunisation scheduling. The working prototype demonstrates this today.
Maternal and child danger-sign recognition with clear, actionable guidance for the field worker.
Structured, offline-capable handoff the patient carries across care levels.
FHIR-compatible data layer connecting community-level records to national EHR systems.
Partner with us
We are looking for NGOs, health programmes, and field partners to co-develop a pilot. If you work with frontline health workers, get in touch.
