feat(ocr, risk): add patient OCR and risk assessment

feat: add patient update API and improve admin scripts

feat: add staff onboarding, password setup and welcome emails

refactor: replace HEALTH_WORKER with FACILITY roles

feat: add facility-scoped access and appointment status

feat: add ANC visit functionality and improve patient/referral workflows

feat: add core maternal health backend features

feat(notifications): add educational notifications

feat: add custom user symptom support

feat(email): add Brevo email service with scheduled alerts and notifications

feat(monitoring): add real-time monitoring engine with state management

Initial backend deployment with Docker and Cron jobs