Randomized Cluster Trial in 250 villages of rural Maharashtra
ARMMAN conducted a three-year Randomized Cluster trial, funded by UKAID, in 250 villages in Osmanabad, Solapur and Washim districts of rural Maharashtra, from January 2013 until December 2015, in which one of the tested interventions was mMitra. In addition to voice calls, the intervention included eight animation videos coded onto the phones of health workers to involve the family in the care of the woman and child.
End-of-pregnancy impact: a) 36% increase in the proportion of women who knew the importance of taking 100 days of IFA (iron folic acid) tablets during pregnancy (p < 0.05)b) 21.66% increase in the number of pregnant women who took IFA (iron folic acid) tablets for 100 days (p < 0.05)c) 46.95% increase in the proportion of women who knew at least three methods of family planning (p < 0.05)d) 29.95% increase in the proportion of women who knew that consistent condom use can reduce chances of contracting HIV/AIDS (p < 0.05)e) 89.32% of the enrolled women received 70% of the voice messages and were satisfied with the content
End-line survey (conducted at the end of infancy) impact:a) 33.79% increase in the proportion of infants who received ORS for an episode of diarrhoea (p < 0.05)b) 48.46% increase in the proportion of infants who were exclusively breastfed (p < 0.05)c) 43.4% increase in the proportion of infants who had their weight checked at least thrice in infancy (p < 0.05)d) 13.5% increase in the proportion of infants who tripled their birth weight at the end of one year (p < 0.05)
Some findings published in the Indian Journal and Maternal and Child Health can be accessed here: https://docs.google.com/a/ijmch.org/viewer?a=v&pid=sites&srcid=aWptY2gub3JnfHd3d3xneDoxYWIxZmU3OTAyMTBmNzcw
Results of an end-of-pregnancy midline survey conducted among mMitra beneficiaries at an urban tertiary care center (Sion Hospital) in Mumbai indicate that mMitra voice calls (without animations) have impact:
a) 96% of women sought treatment for complications during pregnancy as opposed to only 72% of women in the baseline study (p < 0.05).
b) Only 9% of women suffered from pregnancy-related complications in the midline survey as opposed to 38% in the baseline study (p < 0.05)
c) 27% of women in the midline survey knew that IFA supplementation needs to be taken for 100 days as opposed to only 0.5% women in the baseline (p < 0.01).
d) 83% of women were aware of the period of exclusive breastfeeding as compared to 66% during the baseline study (p < 0.01)
e) 91% of women were aware of the importance of giving colostrum to the baby in the midline survey as opposed to 72% in the baseline (p < 0.01)
f) 88% of women in the midline survey were aware of the harmful effects of pre-lacteal feeds as opposed to only 41.35% in the baseline study.
g) Almost 97% of women were aware about the importance of immunization during pregnancy upon follow-up compared to the 61% at baseline (p < 0.01).
h) About 93% of respondents were aware about immunization schedules during infancy during the follow-up compared to 71% at baseline (p < 0.01).
i) Almost all the respondents were satisfied with the voice messages (99%), information received in voice messages (99%), quality of the voice calls (99%) message length (98%), language (99%), frequency (97%), timeliness (95%) and relevance of the information (95%) provided.
Focus group discussions conducted through the ‘Impact of mMitra Voice Call Service on Women’s Involvement in Health Care Decision Making’ study in Mumbai indicate high levels of satisfaction with voice calls.