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. 2020 Dec;10(2):021005.
doi: 10.7189/jogh.10.021005. Epub 2020 Dec 19.

Impact of mHealth interventions for reproductive, maternal, newborn and child health and nutrition at scale: BBC Media Action and the Ananya program in Bihar, India

Victoria C Ward  1 , Hina Raheel  1 , Yingjie Weng  2 , Kala M Mehta  1   3 , Priyanka Dutt  4 , Radharani Mitra  4 , Padmapriya Sastry  4 , Anna Godfrey  5 , Melissa Shannon  5 , Sara Chamberlain  4 , Rajani Kaimal  2 , Suzan L Carmichael  1   6 , Jason Bentley  2 , Safa Abdalla  1 , Kevin T Pepper  1 , Tanmay Mahapatra  7 , Sridhar Srikantiah  7 , Evan Borkum  8 , Anu Rangarajan  8 , Swetha Sridharan  8 , Dana Rotz  8 , Priya Nanda  9 , Usha Kiran Tarigopula  9 , Yamini Atmavilas  9 , Debarshi Bhattacharya  9 , Gary L Darmstadt  1   6 ; Ananya Study Group
Collaborators, Affiliations

Impact of mHealth interventions for reproductive, maternal, newborn and child health and nutrition at scale: BBC Media Action and the Ananya program in Bihar, India

Victoria C Ward et al. J Glob Health. 2020 Dec.

Abstract

Background: Mobile health (mHealth) tools have potential for improving the reach and quality of health information and services through community health workers in low- and middle-income countries. This study evaluates the impact of an mHealth tool implemented at scale as part of the statewide reproductive,maternal, newborn and child health and nutrition (RMNCHN) program in Bihar, India.

Methods: Three survey-based data sets were analysed to compare the health-related knowledge, attitudes and behaviours amongst childbearing women exposed to the Mobile Kunji and Dr. Anita mHealth tools during their visits with frontline workers compared with those who were unexposed.

Results: An evaluation by Mathematica (2014) revealed that exposure to Mobile Kunji and Dr. Anita recordings were associated with significantly higher odds of consuming iron-folic acid tablets (odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.8-3.1) as well as taking a set of three measures for delivery preparedness (OR = 2.8, 95% CI = 1.9-4.2) and appropriate infant complementary feeding (OR = 1.9, 95% CI = 1.0-3.5). CARE India's Community-based Household Surveys (2012-2017) demonstrated significant improvements in early breastfeeding (OR = 1.64, 95% CI = 1.5-1.78) and exclusive breastfeeding (OR = 1.46, 95% CI = 1.33-1.62) in addition to birth preparedness practices. BBC Media Action's Usage & Engagement Survey (2014) demonstrated a positive association between exposure to Mobile Kunji and Dr. Anita and exclusive breastfeeding (58% exposed vs 43% unexposed, P < 0.01) as well as maternal respondents' trust in their frontline worker.

Conclusions: Significant improvements in RMNCHN-related knowledge and behaviours were observed for Bihari women who were exposed to Mobile Kunji and Dr. Anita. This analysis is unique in its rigorous evaluation across multiple data sets of mHealth interventions implemented at scale. These results can help inform global understanding of how best to use mHealth tools, for whom, and in what contexts.

Study registration: ClinicalTrials.gov number NCT02726230.

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Conflict of interest statement

Competing interests: The authors have completed the ICMJE Unified Competing Interest form (available on request from the corresponding author) and declare no other competing interests.

Figures

Figure 1
Figure 1
Exposure to Mobile Kunji and Dr. Anita in eight focus districts and thirty non-focus districts, Community-based Household Surveys, Bihar, India, 2012-2017.
Figure 2
Figure 2
Comparison of reproductive, maternal, newborn and child health and nutrition behaviours for maternal household respondents in eight focus districts who were exposed to Mobile Kunji vs those who were unexposed across rounds 2-9 of the Community-based Household Surveys, Bihar, India, 2012-2017.
See this image and copyright information in PMC

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