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. 2021 Jul;6(Suppl 5):e005538.
doi: 10.1136/bmjgh-2021-005538.

Implementing health communication tools at scale: mobile audio messaging and paper-based job aids for front-line workers providing community health education to mothers in Bihar, India

Victoria Ward  1 , Safa Abdalla  1 , Hina Raheel  1 , Yingjie Weng  2 , Anna Godfrey  3 , Priyanka Dutt  4 , Radharani Mitra  4 , Padmapriya Sastry  4 , Sara Chamberlain  4 , Melissa Shannon  3 , Kala Mehta  1   5 , Jason Bentley  2 , Gary L Darmstadt Md  6 ; Ananya Study Group
Collaborators, Affiliations

Implementing health communication tools at scale: mobile audio messaging and paper-based job aids for front-line workers providing community health education to mothers in Bihar, India

Victoria Ward et al. BMJ Glob Health. 2021 Jul.

Abstract

Introduction: As part of an investment by the Bill & Melinda Gates Foundation to support the Government of Bihar to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) statewide, BBC Media Action implemented multiple communication tools to support front-line worker (FLW) outreach. We analyse the impacts of a package of mHealth audio messaging and paper-based job aids used by FLWs during government-sponsored village health, sanitation and nutrition days (VHSNDs) on knowledge and practices of childbearing women across the RMNCHN continuum of care.

Methods: Data from two surveys collected between July and September 2016 were analysed using logistic regression to compare health-related knowledge and behaviours between women who had been exposed at VHSNDs to the mHealth GupShup Potli (GSP) audio recordings or interpersonal communication (IPC) tools versus those who were unexposed.

Results: Exposure to GSP recordings (n=2608) was associated with improved knowledge across all continuum-of-care domains, as well as improved health-related behaviours in some domains. The odds of having taken iron-folic acid (IFA) tablets were significantly higher in exposed women (OR 1.5, 95% CI 1.1 to 2.2), as was contraceptive use (OR 2.0, 95% CI 1.2 to 3.2). There were no differences in birth preparedness or complementary feeding practices between groups. Exposure to IPC paper-based tools (n=2002) was associated with a twofold increased odds of IFA consumption (OR 2.3, 95% CI 1.7 to 3.2) and contraceptive use (OR 1.8, 95% CI 1.2 to 2.8). Women exposed to both tools were generally at least twice as likely to subsequently discuss the messages with others.

Conclusion: BBC Media Action's mHealth audio messaging job aids and paper-based IPC tools were associated with improved knowledge and practices of women who were exposed to them across multiple domains, suggesting their important potential for improving health outcomes for beneficiaries at scale in low-resource settings.

Trial registration number: NCT02726230.

Keywords: child health; maternal health; paediatrics; prevention strategies; public health.

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Conflict of interest statement

Competing interests: None declared.

References

    1. Alkema L, Chou D, Hogan D, et al. . Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the un maternal mortality estimation Inter-Agency group. Lancet 2016;387:462–74. 10.1016/S0140-6736(15)00838-7 - DOI - PMC - PubMed
    1. Chopra M, Sharkey A, Dalmiya N, et al. . Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition. Lancet 2012;380:1331–40. 10.1016/S0140-6736(12)61423-8 - DOI - PubMed
    1. Victora CG, Requejo JH, Barros AJD, et al. . Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival. Lancet 2016;387:2049–59. 10.1016/S0140-6736(15)00519-X - DOI - PMC - PubMed
    1. Haines A, Sanders D, Lehmann U, et al. . Achieving child survival goals: potential contribution of community health workers. Lancet 2007;369:2121–31. 10.1016/S0140-6736(07)60325-0 - DOI - PubMed
    1. Bhutta ZA, Chopra M, Axelson H, et al. . Countdown to 2015 decade report (2000-10): taking stock of maternal, newborn, and child survival. Lancet 2010;375:2032–44. 10.1016/S0140-6736(10)60678-2 - DOI - PubMed

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