Exposure Visit to MAMA (Mobile Alliance for Maternal Action) Program of Bangladesh

Exposure Visit to MAMA (Mobile Alliance for Maternal Action) Program of Bangladesh

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December – 2015

 

I.   Executive Summary

The overall objective of the trip has been to learn from the Aponjon (Bangladesh MAMA program) experiences and to exchange information between Aponjon and Health Promotion Staff of Ministry of Public Health about the MAMA (Mobile Alliance for Maternal Action) program. The learning has been through workshop presentations, site visits, question and answer sessions and discussions. The team has learned about the Bangladesh MAMA program, especially, about the SBCC (Social and Behavior Change Communication) and ICT (Information Communication Technology) aspects of the program.  ICT tools for disseminating the health messages, specifically, the MAMA messages have been tested and considered, and the team discussed the content development as well as the project approach in more details. The topics covered during the program were specifically about the program introduction, call center & counseling line, marketing & acquisition, content development, web & app service, PMRS and program sustainability.  The team has also had few field visits to SYNESIS IT vendor, BRAC regional office and operational unit of the Brand Promoters (BPs) where they practically observed how the project was running.

 

II. Background

ponjon is the name of the project that works to increase awareness of pregnant and new mothers in Bangladesh. The objective of the project is to improve maternal and child health through health communication and demand generation for maternal health services. The program is to send health messages about pregnancy and child health to the pregnant and new mothers through the mobile phone services. “Aponjon” in Bangla language means (“the close one/dear one /trusted one ‘’) is a mobile phone based (mhealth) service for expecting and new mothers in Bangladesh under the auspices of Mobile Alliance for Maternal Action (MAMA). Aponjon services are operated under the program agreement between the governments of the United States and Bangladesh. Aponjon services are available in text and voice forms through the telecommunication companies such as Grameen phone, Bangla link, Robi, Airtel and City cell; very soon, the other telecommunication operator; Tele talk will be connected, and a number of new services will come under the umbrella of Aponjon as well.

 In September 2011, Aponjon service was launched in 13 locations of four districts of Bangladesh with about 1500 subscribers. The national scale up operation of Aponjon started in August, 2012.  Aponjon envisions reaching more than 2 million mothers by 2015. The service is targeted towards expecting mothers, new mothers with a one- year baby and their family members. Expecting and new mothers are the primary subscribers while the husband, mother, mother-in-law and any other relative can be part of the service, and they are the secondary subscribers. Once registered, the primary subscribers receive two messages, and their family members receive one message per week. The message is tuned to stage of pregnancy or motherhood. For making it customized to the stage of pregnancy or motherhood, a subscriber needs to give the last menstrual period (LMP) date or expected delivery date (EDD). Starting from the sixth week of pregnancy, a mother can receive the service for a maximum period of 89 weeks. A subscriber can deregister any time, can listen to past messages or listen to the same message repeatedly.

The messages’ content has been adopted from the MAMA global, but they have been adapted to the country context through continuous technical working of newborn, maternal and social experts, and then the messages have been pre-tested with the target audiences. The messages then have been edited according to the people’s comments and perceptions. There have been two forms of assessments for the program. Once before launching the program; the people have been asked about maternal and child health, and what was the level of knowledge and awareness within them as well as what their expectations were about the future program of the health communication. The target audiences were mothers in urban and rural areas.

Then, according to the people’s perceptions and expectations received from the formative assessment, feedback from Baby Center, and with the auspices of MAMA global, the message contents were developed. The new developed messages were tested again with the target people over and over for correction and adaptation.

The total IVR recorded messages for Aponjon program is 344 which they are for expecting mothers, new mothers, as well as the gate keepers.

 

III. Purpose:

This exposure visit program aims to enhance participants’ knowledge through exposure to best practices in health communication, usage of ICT tools for Aponjon program, other public health activities, field visit of the outreach partners and the Aponjon call centers.

 

IV. Objectives

The following points are the objectives of this exposure visit:

  • To know about the content development of the maternal and child health messages.
  • To get to know how the program is running from health communication point of view; who are the target audience, and how and when they get the messages.
  • To explore the contract procedure between Aponjon and Mobile Network Operators/Vendors
  • To understand the Business logic of sending IVR and SMS to the targeted users
  • To get to know the methods of finding and registration of targeted users though Mobile Technology
  • To understand the challenges while piloting the Aponjon program
  • To get familiar with the Aponjon reporting applications for the disseminated SMS/IVR
  • To enable ICT team for better implementation of the MAMA Program with acquired experience from the visit

 

V.  Lessons learned

Lessons learned from the exposure visit enables the Health Promotion team and partners for better implementation of MAMA program.

1.     Registration of the targeted Population

During the exposure visit the Health Promotion team found out that the following techniques can be used to register the targeted users.

  • Call Center (talk with agent and get registered)
  • Self-registration through Interactive SMS/IVR
  • Registration via Aponjon website and mobile application
  • Through physical form (outreach partners will fill the forms and submitted to the Aponjon office for quality control and registration)

Aponjon pay incentive for each valid registration (users should receive at least 8 SMS/IVR within 2 months to be called as the valid client) to the outreach partners.

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Outreach form process

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Registration Approval

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Registration through SMS Request

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Date Birth (DoB) Update

 

 

 

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2.     Messages and Content

Aponjon use Banglish words (Bangla language written in English characters) instated of their local language in the message and for the IVR they use Bangla language; in the audio format they use ‘formal’ tone, where the central character “MoniApa” (sister doctor), preferably a health worker to convey the messages. There are 344 messages for different types of clients. The primary target audience is expecting and new mothers, while the second audience is the gate keepers which include husbands, mothers-in-law, and other members of the family. The messages have been developed in four stages and there are four versions of the messages. The messages are separately customized for urban and rural/ semi urban/slum populations.

 

3.     MNOs/Vendor Contract

There are 6 MNOs and 5 vendors which all have SMS/IVR platform in Bangladesh. The Aponjon project has contracted with one vendor (SSD tech). The vendor company is responsible for the SMS/IVR platform, connectivity to MNOs, routing calls to the call center, developing reporting application and disseminating SMS/IVR to the Aponjon users. Meanwhile, Aponjon has contract with all MNOs in Bangladesh for charging the users and disseminating the SMS/IVR messages.

 

4.     BTRC Involvement

Aponjon got approval of Bangladesh Telecom Regulatory Commission for SMS/IVR broadcast and a dedicated short code for the project. In Bangladesh all MNOs are connected to a government’s server called (Inter Connection Exchange) which reduce the issues of routing calls from one MNO to another.

 

5.     Cost

All the Aponjon users should pay 2 Taka (Bangladesh currency) for each SMS/IVR message.  Aponjon receives its income from MNOs based on the revenue share.

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