When data flows without you
Lessons on nonprofit-government data integration from four Indian states.
Ask any service delivery nonprofit what their dream end goal is, and you’ll likely hear some variation of: “For the government to completely own our programs so that they’re sustainable long-term.”
At Noora Health, we share this dream. And to some extent, we’ve managed to achieve it through our implementing partners who have been working closely with state governments to embed the Care Companion Program (CCP) within India’s public health system. However, one critical piece remains: monitoring data.
Data integration often decides whether programs become truly government-owned or remain dependent on nonprofit oversight.
When governments can’t independently monitor performance, they risk becoming passive recipients rather than active program owners — unable to make informed decisions, course-correct, or scale effectively. As India’s public health systems increasingly adopt digital tools, the opportunity to embed program data directly into these systems has grown.
In this article, we reflect on our experience of integrating monitoring systems across four states in India — Andhra Pradesh, Himachal Pradesh, Punjab, and Madhya Pradesh. We share what’s worked, some challenges, and other considerations to keep in mind for organizations pursuing similar partnerships.
Three models, four contexts
Working with government partners across India, we’ve seen that there’s no universal solution or blueprint to data integration. Each state has its own technical capacities, priorities, and existing systems, and so every partnership needs a tailored approach.
As a result, within our single program across India, we’ve developed three distinct integration models (with more potentially in the pipeline!). Although managing multiple approaches takes more time, it’s proven essential for long-term sustainability.
Path 1: Leveraging existing monitoring platforms
One of the most effective approaches we’ve seen is leveraging trusted government platforms, allowing the CCP to integrate seamlessly into the existing public health reporting ecosystem. This not only aligns with the government’s consistent emphasis on avoiding parallel reporting systems but also reduces the burden on healthcare workers, who are already well-versed in these tools.
In Punjab and Himachal Pradesh, for instance, we integrated CCP data into the reporting for wellness sessions on the Ayushman Bharat – Health and Wellness Centre (AB-HWC) portal, which tracks and manages services provided at primary healthcare centers across India, making it a natural home for CCP data. Using the AB-HWC portal also helped position the program as a trusted government initiative, rather than an external effort, motivating healthcare workers to conduct sessions regularly and take ownership of the work.
In Andhra Pradesh, we adopted a similar strategy by integrating with the existing CHO AP Health mobile application — yielding many of the same benefits. The scale of adoption has been remarkable, with over 1,000 sessions reported daily on average by 9,000+ community health officers through this platform alone.
Path 2: Co-designing an app with the government
In states with more advanced technological capacities, we’ve built on that strength to inform our approach. In Andhra Pradesh, this resulted in co-creating a version of the CCP app with the state government, tailored to their requirements. Originally, when presented with our in-house app, the government appreciated its ease of use for data recording and recognized its potential to help overcome long-standing skepticism toward digital reporting platforms among healthcare workers in secondary and tertiary facilities. However, confident in their own in-house tech capabilities, they preferred to co-create a modified version, where they would directly monitor and retain ownership of the data.
This pathway is a win-win: the government retains control and oversight of the system, while we’re able to scale deployment without needing additional permissions or resources for maintaining the application. Just as importantly, this project helped strengthen our relationship with the state’s tech team — a crucial step for sustaining reporting systems in the long term.
Path 3: Integrating data into government dashboards
A third option our teams have explored is to integrate CCP data directly into government health dashboards, as is happening in Andhra Pradesh and Madhya Pradesh. Since government health officials already use these dashboards to track a range of health initiatives, displaying CCP data alongside other indicators enhances trust and credibility, showing that the program complements, rather than competes with, existing systems.
This integration helps governments track progress toward their own health goals while making it easier for district and state officials to monitor the program without juggling multiple systems. The continuous visibility of CCP activities also enables officials to identify gaps in service delivery and make better-informed planning decisions. Additionally, we’ve seen that rooting the program in the state’s own infrastructure helps strengthen its sustainability, making it more resilient to administrative change.
Hard truths and trade-offs
Working with government partners is extremely rewarding but rarely straightforward. It means adapting to realities that aren’t always easy, and recognizing that each approach comes with trade-offs — between speed, sustainability, and user adoption. Our role is to navigate these tensions without losing sight of our ultimate goal of providing better care to patients and families. Here are some things to consider if you’re planning to go down one of these pathways:
1. Technical capacity varies widely
No two partners will have the same technical capacity, interest in data integration, and willingness to invest in tech solutions. Some states have sophisticated in-house tech teams eager to build custom solutions; others have limited infrastructure and are wary of new tools. It’s crucial to be mindful of these differences and adapt expectations accordingly.
What helps: Assess a government’s technical readiness early on, in order to pitch a relevant solution — whether that’s your own app, embedding into an existing portal, or starting with smaller data-sharing pilots.
2. Customization isn’t always possible
Official reporting mechanisms reflect the government’s priorities: What data matters to them, how it’s collected, and how it’s used. This can mean limited room for tailoring tools or processes to partner or user needs. Instead, programs often have to adapt to existing systems and formats, even when that means compromising on certain features or timelines. The quality of these tech platforms and the user experience may also not be on par with industry standards, which can be frustrating for the organization delivering the program.
What helps: Get creative and accept that ‘good enough’ is usually sufficient, as long as the platform is functional, reliable, and usable for frontline staff. One lesson we learned as we moved further into the integration process is that the need to compromise arose more often than initially anticipated. However, we tried to avoid viewing this as a limitation, seeing it instead as an opportunity to reassess and clarify the bare minimum and truly non-negotiable elements needed for successful integration.
3. Timelines will test your patience
Government processes take time, and technical interventions bring an added layer of complexity that can stretch timelines even more. Priorities shift, resources are limited, and integration work can be pushed to the back burner. Progress is rarely linear and predictable — timelines can shift quickly, and you may find yourself intensely testing an app one week and waiting weeks for an update the next.
What helps: It’s important to maintain a pragmatic view of the situation. Governments operate across multiple levels, and their capacity is often stretched, so new processes are inevitably going to take time. In our case, we regularly monitored the situation, followed up, and kept our team ready to act at a moment’s notice. Having ‘eyes on the ground’ was crucial — our program teams could read the mood, sense when decision-makers might be more open to changes, and step in with requests at just the right time.
4. Relationships matter more than processes
Even though we live in a post-pandemic, online-first world, key meetings and decisions often work best in-person, given the many requests and priorities they manage. We saw many instances where actions pending for months were resolved within minutes once things were explained and communicated face-to-face, on both sides.
What helps: Spend time and effort on building strong interpersonal relationships with officials. It’s incredibly helpful to consistently try to understand their challenges, empathize with their situations, and offer whatever support is feasible. Approaching things this way fosters a collaborative relationship where both parties benefit, rather than it becoming merely transactional. Additionally, we’ve found that speaking the same language as our government partners — literally — makes a meaningful difference. Especially during technical discussions, it signals respect, improves mutual understanding, and goes a long way in building trust and positioning us as empathetic, approachable collaborators.
At Noora Health, we’ve seen firsthand how embedding reporting into government platforms strengthens programs, motivates healthcare workers, and makes our work resilient to change. It’s shown us that data integration isn’t just a nice-to-have backend feature — it’s foundational to long-term sustainability. Because the real handover doesn’t happen when implementation stops, it happens when data flows without us. And when data lives within public systems, so does accountability.
We’re grateful to the health departments of Andhra Pradesh, Himachal Pradesh, Madhya Pradesh, and Punjab, for opening their doors, sharing their data, and trusting us as partners in this work.
This article was made possible with contributions from Deepali Thakur and Bhanu Pratap Yadav, editing support from Shreya Adhikari and Tanaya Jagtiani, and graphics by Rohina Thapar — thank you!
G. Hassan Kumar
Product Manager
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