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Six lessons I learnt while trying to reach 10 million women in India with life-saving health information

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Priyanka Dutt shares what she has learned while implementing a mobile health program for women in India.

Kilkari mobile messagingLast month, the Government of India launched a nationwide mobile health (mHealth) program designed by BBC Media Action, the BBC’s international development charity. The aim - to train 1 million community health workers and help nearly 10 million new and expecting mothers in India make healthier choices and lead longer, healthier lives.
 
Mobile Academy is an anytime, anywhere audio training course, delivered via mobile phone, designed to refresh the knowledge and strengthen the communication skills of community health workers. The objective is to enable the nation’s nearly one million health workers to more effectively persuade families to lead healthier lives.
 
Kilkari  (a baby’s gurgle) service delivers free, weekly, time-appropriate audio messages about pregnancy, childbirth, and childcare directly to the mobile phones of mothers and other family members from the second trimester of pregnancy until the child is one year old.

These services were originally designed for use in Bihar in North India, where BBC Media Action, in partnership with the state government works to improve demand for health services, improve social norms and impact health outcomes for mothers and children. Read more.

Mobile Academy and Kilkari leverage the massive penetration of mobile phones to reach the most marginalized, hardest-to-reach communities in India. These are communities where getting pregnant and having babies can be 24 times more life-threatening than giving birth in the United Kingdom!
 
The statistics are pretty stark. Globally, every five minutes, three women die from complications related to pregnancy or childbirth, while 60 others will be left with debilitating injuries. Of these deaths, India accounts for the greatest number of women dying – over 150 every day. But we know how many of these health risks that pregnant women and their newborns face are preventable.

In a country where nearly a billion people have access to mobile phones, the potential to save lives through insightful, innovative communication marks a paradigm shift.
 
So, what have I learnt about leveraging technology to reach the seemingly unreachable?

First: strategic targeting. One of the BBC values is: audiences are at the heart of everything we do. We believe it is critical to understand audiences before you begin. Ask the right questions, get the right research, mine the data for insights about your target audience,before you begin to design your intervention.
 
Second: appropriate technology. Understand what technology your audiences have, what they already use, and design your program around that. That will help get around the challenges of procuring, distributing, maintaining and replacing expensive new hardware.
 
Third: content is king. In order to get a desired response, the stimulus – or content – must be specially designed. Messaging is not the same as communication. Make information accessible. Don’t preach; talk. Make content sticky and memorable. And speak in a style that’s widely understood and accepted, using language that’s rich in local idiom and flavor.

Mobile AcademyKilkari and Mobile Academy are both presented in the voice of a female doctor character, called Dr Anita. Dr Anita was designed with the express aim of being trusted and respected by community health workers and families alike. She is the voice of authority, but has a great bedside manner and speaks the local language.  For families who rarely have the opportunity to see a doctor face to face, Dr Anita is a powerful tool.

Fourth: user-centric design. Test, test and test again, before you implement. Make sure your audience and users can easily access, use and understand your communication. Test your content to make sure it’s relevant, engaging and easily comprehended. User-test your technology to confirm that it is truly simple and intuitive for your audience to use.

Fifth: design for scale. Start out with the assumption that your program will be implemented across the country, and plan based on that assumption. Don’t test a Rolls Royce model, if what can be scaled up is only a Hyundai!
 
And finally: partnerships. Public and private sector partnerships underlie sustainability. BBC Media Action’s partnership with the government is supported by its partnerships with the Bill & Melinda Gates Foundation, USAID and the Barr Foundation. This makes it possible for our mHealth services to touch millions of lives, and have significant impact at an unprecedented scale. 
 
Kilkari is now making calls to 850,000 families in six states, and will rapidly scale to reach almost 10 million new and expecting mothers a year. Mobile Academy is currently accessible to 150,000 health workers across four states, and will scale to reach nearly a million health workers.
 
We should all be excited by the potential for technical innovation to improve the lives of many, especially the lives of some of the very poorest in the world. New and better technology will transform health systems, by digitizing health records, by diagnosing conditions straight from the phone, by doing a lot of amazing things.
 
There is also beauty in simplicity - in the here and now. While we wait for these new technologies to take hold, and to become ubiquitous, if we use what people have in their hands, we can start saving lives now.



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Priyanka Dutt is the Country Director, India for BBC Media Action. With over 15 years' experience, Priyanka is a senior communication expert who focuses on social and behavioural change communication. She has a background in producing and directing factual television. She works with the BBC Media Action on television, advertising, radio, mid media, outreach and mobile outputs, primarily for health projects.

Photos courtesy of BBC Media Action

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