Abstract

Introduction

Mobile Vaani was implemented as a pilot programme across six blocks of Nalanda district in Bihar state, India to increase knowledge of rural women who were members of self-help groups on proper nutrition for pregnant or lactating mothers and infants, family planning and diarrhoea management. Conveners of self-help group meetings, community mobilisers, introduced women to the intervention by giving them access to interactive voice response informational and motivational content. A mixed methods outcome and embedded process evaluation was commissioned to assess the reach and impact of Mobile Vaani.

Methods

The outcome evaluation, conducted from January 2017 to November 2018, used a quasi-experimental pre–post design with a sample of 4800 married women aged 15–49 from self-help group households, who had a live birth in the past 24 months. Surveys with community mobilisers followed by meeting observations (n=116), in-depth interviews (n=180) with self-help group members and secondary analyses of system generated data were conducted to assess exposure and perceptions of the intervention.

Results

From the outcome evaluation, 23% of women interviewed had heard about Mobile Vaani. Women in the intervention arm had significantly higher knowledge than women in the comparison arm for two of seven focus outcomes: knowledge of how to make child’s food nutrient and energy dense (treatment-on-treated: 18.8% (95% CI 0.4% to 37.2%, p<0.045)) and awareness of at least two modern spacing family planning methods (treatment-on-treated: 17.6% (95% CI 4.7% to 30.5%, p<0.008)). Women with any awareness of Mobile Vaani were happy with the programme and appreciated the ability to call in and listen to the content.

Conclusion

Low population awareness and programme exposure are underpinned by broader population level barriers to mobile phone access and use among women and missed opportunities by the programme to improve targeting and programme promotion. Further research is needed to assess programmatic linkages with changes in health practices.

Details

Title
Key learnings from an outcome and embedded process evaluation of a direct to beneficiary mobile health intervention among marginalised women in rural Bihar, India
Author
Irani, Laili 1   VIAFID ORCID Logo  ; Verma, Supriya 2 ; Mathur, Ruchika 2 ; Verma, Raj Kumar 2 ; Mohan, Diwakar 3 ; Dhar, Diva 4 ; Aaditeshwar Seth 5 ; Chaudhuri, Indrajit 6 ; Mahua Roy Chaudhury 7 ; Purthy, Apolo 7 ; Nanda, Ankit 2 ; Singh, Shivani 2 ; Gupta, Akshay 5 ; LeFevre, Amnesty Elizabeth 8   VIAFID ORCID Logo 

1  Population Council, New York, New York, USA 
2  Population Council, Delhi, India 
3  Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA 
4  Bill & Melinda Gates Foundation, Seattle, Washington, USA 
5  Gram Vaani, Delhi, India 
6  Project Concern International, San Diego, California, USA 
7  Department of Rural Development, Government of Bihar, JEEViKA, Bihar Rural Livelihoods Promotion Society, Patna, India 
8  University of Cape Town, School of Public Health and Family Medicine, Cape Town, Western Cape, South Africa 
First page
e052336
Section
Global health
Publication year
2022
Publication date
2022
Publisher
BMJ Publishing Group LTD
e-ISSN
20446055
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1136/bmjopen-2021-052336
ProQuest document ID
2724109790
Copyright
© 2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.