The Communication Initiative
Development action with informed and engaged societies
The Communication Initiative
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Seven lessons from scaling up mHealth in India

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Our challenge: How do we ensure families in India have timely information about childbirth, childcare and family planning, during pregnancy and in the first year of the child's life? The innovation: High-quality health information and advice to Indian families - particularly in rural areas – through the growing use of basic mobile phones. Our human-centred design mobile health solution has been scaled to 17 states by the Government of India to empower families and frontline health workers to improve child mortality and maternal health. Kilkari (a baby’s gurgle) is our mobile messaging service designed to reinforce frontline health workers’ counselling by delivering information to families to help healthier choices and lives. Combined with tools and training for frontline health workers – our Mobile Academy training course, and Mobile Kunji tool to support frontline workers in communicating with families - the service is strengthening this ‘last mile’ of the health system, to increase their knowledge, skills and confidence in communicating, and reinforcing their information. Aiding with all of this is the trusted voice of ‘Dr Anita', the fictional narrator across our suite of mHealth services – Mobile Academy, Mobile Kunji and Kilkari – providing health information, guidance and friendship to families across India. Kilkari’s free, weekly, stage-based audio messages about pregnancy, childbirth, childcare and family planning are delivered directly to families’ phones as one pre-recorded call per week for 72 weeks, linked to the stage of pregnancy or child’s age and timed for the highest-risk periods, between the second trimester of pregnancy until the child is a year old. Available in five languages – Hindi, Bihari, Oriya, Assamese and Bengali – family mobile phones are automatically subscribed as soon as a pregnancy is registered in the government database. Following two independent evaluations and analyses from Johns Hopkins University and Stanford University, now published in a special supplement of BMJ Global Health, here are the lessons we learned over a decade of digital development:

Comments

Thanks for sharing. I found this blog (above which is an excerpt of, I believe) to be useful, considering how much information we have on The CI site about Kilkari. One of the lessons learned was that "timed and targeted information can improve modern contraceptive use and immunisation". Specifically, as the BBC Media Action blog indicates (data from the RCT, which as we know - was conducted by JHU): "When Dr Anita gave advice on condom use, people listened: Those who listened to Kilkari were associated with a 3.7% higher use of modern reversible contraceptives; the number rose to 7.3% among those who heard 50% or more of Kilkari content, compared to non-listeners – largely driven by increased condom use. Effects were even larger for families with a male child (9.9% increase), in the poorest socioeconomic strata (15.8% increase), and in disadvantaged castes (12.0% increase). The evaluation also found higher rates of immunisation among infants at 10 weeks (2.8%)." It's great to see such rigorous evaluation of communication programmes.