For a long time, my whole relationship with Basic HealthCare Services lived on a screen. Calls, config changes, messages. Screen to screen. In June that changed. I spent six days on the ground in Udaipur, training the people who would actually use the thing we'd been building: the Phulwari workers of BHS.
\nSo this is an account of those six days. The rollout, the people, a heat I was in no way built for and one second where a paper register turned into a live growth chart and quietly ended a week's worth of manual arithmetic. That second is really what this whole blog is about. Everything else is just how I got there.
\nBasic HealthCare Services (BHS) is a not-for-profit founded in 2012 in Udaipur, Rajasthan. It was started by a group of public health professionals around a simple, stubborn idea: that good primary healthcare is a human right and not a privilege, and that it should reach the people who are usually the last to receive it. In their case, that means tribal and migrant communities in some of the remotest pockets of southern Rajasthan, where food scarcity and child malnutrition are part of daily life for a large share of families.
\nThe work runs across a few connected interventions:
\nAvni sits quietly underneath all of this. It does the unglamorous but essential work: replacing paper with structured data, running the calculations the moment a number is entered, and turning a week-long monthly reporting exercise into something that happens almost on its own.
\nA Phulwari is, at its simplest, a village day-care centre for the youngest children - roughly between six months and three years old. Parents, often daily-wage workers, leave their children there for the day, and the Phulwari worker takes care of everything: feeding them, helping them walk, play, read, write, and learn. For a community working against malnutrition, a Phulwari is much more than a crèche. It is a frontline nutrition and early-childhood centre.
\nThe workers themselves are local women, each from the very village her centre serves. Around 50 of them came for the training, drawn from roughly 18 active Phulwaris - one centre, at least one worker from that centre, and soon, one Avni user each.
\nBefore Avni, the workers tracked children on a card, which is really just paper by another name, and kept attendance in a register. The day-to-day was manageable. The pain arrived at month-end.
\nTo produce monthly statistics, someone had to copy everything from those registers into Excel, aggregate it, and only then pull the numbers out. That someone was often Pradeep, from the IT team, and he walked me through his routine. He'd open the photos of the registers that the Phulwaris had sent over WhatsApp, keep his own Excel sheet open on the side, pull up that particular Phulwari's sheet, and mark attendance against each child, one by one, by hand.
\nPradeep is one of the most skilled people I've met with Excel. Watching him key in all of that data manually, one entry at a time, was genuinely a bit sad. He told me himself that this, just marking attendance, cost him a full week, every single month. Twelve weeks a year, gone, retyping numbers that already existed.
\nGrowth monitoring was more involved still: a child's height and weight would be carried to a nearby clinic, a nurse would be found, and that nurse would manually compute the Z-scores and the L, M, S values, and from those determine each child's growth status - whether the child was SAM (Severe Acute Malnutrition), MAM (Moderate Acute Malnutrition), or severely underweight.
\nIt worked. But it was slow, and it leaned on a long chain of people and paper holding together perfectly, every single time. Remember Pradeep's week. We're going to give it back to him.
\nI will be honest: the journey humbled me before the work even began. It was my first-ever connecting flight, and it was more tiring than I had expected. By the time I landed at Udaipur airport, the BHS head office was still about an hour's drive away, and I was running on empty. I would like to say I took in the scenery on that drive, but I mostly concentrated on keeping my eyes open.
\nThe head office sits inside a college called VBRI, where BHS has rented a building to use as its HO. Lovely place, genuinely, with one catch: the heat. For someone who lives in Bangalore, the Udaipur summer was almost unbearable. But once I stopped sulking about the temperature, I noticed the peacocks. The training was at a centre a short 15–20 minute walk from the office. I'll admit my heart sank a little when I walked in and saw the crowd. Somewhere between 50 and 60 people. I've done plenty of field visits before, but never at this scale, and never quite this kind of session. First time on a few counts. After a quick round of intros, we got going. I started with the basics: what the app looks like, how to log in, and then the home dashboard, which was going to be their most important screen. It's built around six main cards, due and overdue visits for anthropometry, attendance, and child-absent follow-up, plus three indicator cards that flag the children who are SAM, MAM, or severely underweight. We walked through what each card meant and how to move around the app. The language gaps were real. In a few places the app had missing translations, and wherever a screen wasn't fully in their language, workers couldn't always tell what to do next. A lot of them don't read or write English, so even switching the phone's keyboard between Hindi and English turned into its own little hurdle(This was needed because the login credentials were in english). None of this was their fault, and all of it is now on my list to fix before the next visit. I want to make sure not one of these things slows them down again. What stayed with me from day one wasn't the workers who breezed through it. It was the ones who didn't, who were hesitant, not with their phones, which they knew perfectly well, but with a whole new app they suddenly had to learn, and who one entry at a time, got comfortable enough to be registering children by the end of the day anyway. Day two was calmer. We moved on to filling out anthropometry forms, anthropometry being the measurement side of growth monitoring, for the children we'd registered the day before. The form is mercifully simple: weight, height (taken once every three months), and any illness the child might have. And then it happened. A worker entered a measurement, and the app drew a live growth chart, right then and there, and ran the calculations in the same breath. The Z-scores. The L, M, S values. The growth status. On the screen. Instantly. The production setup was completed the day after the training, and the PROD users and credentials were ready the day after that. Each of the 18 active Phulwaris received its own user - one centre, one worker, one login. On that same day, the workers began registering and enrolling children using the app for real. That, to me, is the headline. BHS did not just attend a training. They went live. And remember Pradeep's week? The one he lost every month to retyping attendance off WhatsApp photos? That's the week Avni quietly hands back. The data now lands structured, the aggregation runs on its own, and the month-end marathon that used to eat five days of one of the most capable people on the team just... stops needing to happen. Of everything I saw on this trip, that's the number I'm proudest of. Not one that shows up on a dashboard, but a week times 12 months a year, times a whole team, returned to actual work. Every field visit teaches you something the office never could, and the biggest lesson from this one was about connectivity. The network at the centres was poor - workers could barely log in, and at one point we walked a device some distance away from the Phulwari simply to get enough signal for it to log in and sync. The takeaway was clear: the app needs to work properly offline. Out here, that is not a nice-to-have; it is the whole game. I also learned that I had never, until then, spoken continuously for quite so long, which brings me to the people who carried me through it. Throughout the training, Pradeep, Mansi, and Charishma had my back constantly. Whenever my energy dipped - and over that many hours, it did - Mansi in particular would step straight in to keep the room's enthusiasm and spirit up. I am genuinely grateful to all of them for helping this city kid out. For that, thank you brov 🫡 I also owe thanks to Gauri, Janvi, and several others on the team. As bachelor's and master's degree holders, they could navigate the app comfortably themselves and step in to help the workers the moment anyone got stuck. A rollout like this is never one person's doing, and this one was certainly not. Away from the training, the BHS staff turned out to be wonderful company - my neighbours most of all. The evenings filled up with badminton, rounds of UNO, and long, winding conversations about life, and mostly about treks. By the end of the six days, we had grown close enough to promise we would go on a trek together before too long. If you are reading this, do me a small favour and touch wood, so we do not jinx it. Six days, one connecting flight, a great many peacocks, around 50 workers trained, 18 Phulwaris live, and one growth chart that drew itself and quietly retired a week's worth of manual arithmetic. By every measure I care about, the rollout was a success - and a more joyful one than I had expected. Onwards to the next visit - with offline support, complete translations, and, with any luck, that trek.
\nTraining, Day by Day
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\nThen came the real task: registering and enrolling children. With a little back and forth, most of the workers managed to register and enrol children on their own, which was a genuinely encouraging sign on day one. Some struggled, and the reasons taught me a great deal.The Growth Chart Moment
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\nThis was the moment that made the trip worth it. (At least to me that is).What the Field Taught Me
\nPeople and Process
\nEvenings, Badminton, and a Promise to Trek
\nClosing Thoughts
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