mMitra

mMitra

mMitra is a free mobile voice call service by ARMMAN that sends timed and targeted preventive care information weekly/bi-weekly directly to the phones of the enrolled women through pregnancy and infancy in their chosen language and timeslot.

0
2.30
Million

Women Reached

1
9

States

15
40

NGO Partners

9
97

Hospitals

Rationale

Lack of access to preventive care information is a significant problem underlying the woeful maternal morbidity and mortality numbers. The high mobile penetration in India positions voice calls as an excellent mechanism for reaching women and families with this critical life-saving healthcare information in a timed and targeted manner using the principles of behaviour change communication.

Programme Design

Free automated voice calls on critical information on maternal and infancy care, starting from pregnancy till the child is a year-old. Women are enrolled in the mMitra program through two verticals:

  • Hospital Vertical – Health workers are posted in the antenatal / postnatal clinics of municipal/government/private hospitals and register women during their first check-up visit.
  • Community Vertical – Enrollment in the slum is done through partner NGOs working in slum communities.

Sakhis (community health workers) have been trained who enroll women directly in the early stages of pregnancy for a small incentive.

Salient Features

  • ARMMAN and BabyCenter has developed the messages that have been validated by The Federation of Obstetrics and Gynaecological Society of India (FOGSI) and National Neonatology Forum (NNF).
  • Frequency: 141 individualised voice messages of 60-120 seconds are sent with the following frequency:
    • Pregnancy: Bi-weekly
    • First week after birth: Daily
    • Until Infancy month 3: Bi-weekly
    • Infancy month 4 to Infancy month 12: Weekly
  • Timed & Targeted: The information in the calls is timed to the stage of the pregnancy or age of the infant and is delivered directly to the women.
  • Chosen Timeslot: The calls are sent in the timeslot chosen by the women.
  • Preferred Language: Women can receive the calls in Hindi, Marathi, Kannada and Gujarati.
  • Repeat Calls: There are three tries for every voice message.
  • Missed Call System: If a woman misses all three calls, she can give a missed call to receive a call back.
  • Call-center: A trained counselor can be informed in case of a delivery, abortion or to change the phone number or timeslot.

Customised Components of mMitra

  • Improving adherence to best practices in feeding, health & hygiene among moderately underweight children through telephonic counselling: We have received a grant from GCC to conduct proof-of-concept to study the effectiveness of a telephonic counselling service to handhold mothers of children who are
    moderately underweight while they adopt best practices in feeding, hygiene and health. Trained nutrition counsellors provide advice on nutrition (home recipes), sanitation, hygiene etc via weekly (10-15
    minutes) calls for 8 weeks and fortnightly calls for 2 months thereafter. The project is designed as a randomized control trial involving 800 children between 6 months to 2 years and their caregivers with the
    objective of bringing them in the normal range of weight-for-age.
  • Malnutrition Programme: 120 additional weekly/monthly customised and automated voice calls on nutrition and steps to prevent malnutrition sent to mothers till the child is three.
  • HIV-AIDS Programme: Handholding through weekly voice reminders and call centre for HIV positive women until the child is 18 months of age to prevent vertical transmission of HIV / AIDS from mother to child. This programme is supported by Johnson & Johnson and their ‘Connect For Life’ technology platform. The programme consists of a total of 351 voice messages (offered in Hindi and Marathi) empowering the women with critical information that focuses on foetal development, counselling, medication (ART) reminders, importance of adhering to ART, positive living, right nutrition, breastfeeding, investigative tests and other important guidance. Besides these automated voice messages, the programme also offers automated visit reminder calls and follow-up by the dedicated call centre staff, thus hand holding them through the care process to prevent transmission of HIV/AIDS to the infant. Women Enrolled: 659

Impact

The midline survey results of the pre-post intervention study in Sion hospital and the end line results of the randomized cluster trial conducted in Osmanabad, Solapur and Washim districts of rural Maharashtra (supported by UKAID) have shown a significant impact. Some impact data (p < 0.05) is included below:

  • 25% increase in the number of pregnant women who took IFA tablets for 90 or more days
  • 47.7% increase in proportion of women who knew at least three methods of family planning
  • 26.3% increase in proportion of infants under six months who were exclusively breastfed
  • 17.4% increase in proportion of infants who tripled their birth weight at the end of one year

External evaluation (randomized controlled trial) conducted by Foundation for Research in Health Systems (FRHS) in Mumbai has also been published.

Accolades

  • ARMMAN won the Skoll Award for Social Entrepreneurship.
  • ARMMAN won Maternal and Child Health Team of the Year at British Medical Journal Awards South Asia 2018.
  • ARMMAN won the WHO ‘Public Health Champion’ 2017 award in the Innovation Category.
  • ARMMAN received Zee Media’s Transform India 2017 award.
  • mMitra won the GSK-Save the Children Health Innovation Award 2017. mMitra was one of the four awardees in the world and the first Indian NGO to receive this award out of 170 applicants from 40 countries.
  • mMitra won the Silver award for the “Best Use of Mobile for Social & Economic Development” at the Indian Digital Awards 2017 by IAMAI forum.
  • mMitra was a finalist at Vodafone Foundation’s ‘Mobile for Good Awards 2015’.
  • mMitra won the “People’s Choice Award” at “Saving Lives At Birth” event in 2011 organised by USAID, Bill and Melinda Gates Foundation, World Bank, Government of Norway and Grand Challenges, Canada.