Pilot of an Interactive Voice Response Service for Delivering Maternal Health Information to Expectant Fathers in Pakistan
Summary:
High mobile phone ownership in Pakistan offers a unique opportunity to connect populations that otherwise would not have access to one another. We propose an Interactive Voice Response Service (IVR) to connect gynecologists to expectant fathers, a subgroup that is often the primary decision-maker at home. We developed and piloted Super Abbu (Super Dad), an IVR that delivers maternal health information in Pakistan. Its main features are: 1) a question and answer section that connects users to gynecologists and 2) a story-sharing section that allows users to share experiences with peers. Content is moderated prior to becoming public and can be shared with friends, commented on, voted on, and given open-ended feedback on by users. Findings include: 1) targeted robocalls result in high uptake and audio banner ads on existing IVRs result in high engagement and retention; 2) there is demand for maternal health information by men; 3) there is high approval of a service that delivers culturally sensitive information on reproductive health; 4) content moderators require guidelines on what questions to make public to maintain cultural appropriateness of the service; 5) content moderators require guidelines to prevent the spread of misinformation while protecting users' right to free speech. Super Abbu demonstrates that IVRs can: 1) collect data on the informational needs of marginalized populations about culturally sensitive topics and 2) deliver personalized information to hard-to-reach populations with low education levels. Limitations include limited information on users and health impacts of the service.
Background/Objectives:
High mobile phone ownership in Pakistan offers a unique opportunity to connect populations that otherwise would not have access to one another. We propose an Interactive Voice Response Service (IVR) to connect gynecologists to expectant fathers, a subgroup often excluded from maternal health programs. Informational interventions to promote maternal health-seeking behaviors have better impacts when they include male partners (Tokhi et al., 2018), and this is particularly true in cultures where men are often primary decision-makers, as is the case in Pakistan. We developed and piloted such a service, called Super Abbu (Super Dad), in Pakistan in 2018.
Description of Intervention and/or Methods/Design:
Super Abbu is an IVR that delivers maternal health information over a phone call. Its two main features are: 1) a question and answer section (Q&A) that connects users to gynecologists and 2) a story-sharing section (Stories) that allows users to share experiences with peers. In Q&A, questions are recorded by users, answered by doctors through a mobile application, and recorded by the persona of a female gynecologist. This feature allows users to receive personalized health information in addition to listen to Q&As other users have made public. In Stories, users listen to and record stories about pregnancy and childbirth. Content (Q&As and stories) is moderated prior to becoming publicly available and can be shared with friends, commented on, voted on, and given open-ended feedback on by users. Super Abbu was advertised through robo-calls, audio banner ads on a telephony service, radio, television, Facebook, and flyers.
Results/Lessons Learned:
The 71-day deployment yielded 21,500 users who made 40,000 calls, recorded 11,000 questions, stories, comments and feedbacks, shared content 5,000 times and voted on content 31,000 times. Findings include five lessons learned for deploying a maternal health hotline targeted at men in Pakistan: 1) targeted robocalls lead to high uptake and audio banner ads on existing telephony services result in high engagement and retention; 2) there is high demand for maternal health information by men; 3) there is high (but not total) approval of a service that delivers culturally sensitive information related to reproductive health; 4) content moderators require guidelines on what questions to make publicly available (versus privately available to users who recorded the question) to create and maintain cultural appropriateness of the service; 5) content moderators of user-generated stories require guidelines to prevent the spread of misinformation while protecting users' right to free speech.
Discussion/Implications for the Field:
The pilot resulted in several implications for the development and deployment of a service that connects groups of people that lack access to each other. Super Abbu demonstrates that IVRs can be used to: 1) collect data on the informational needs of marginalized populations about culturally sensitive topics and 2) deliver personalized information to hard-to-reach populations with limited literacy, numeracy and technological skills. Limitations of this pilot include not being able to collect sociodemographic information on all users or draw conclusions about the impact of health information delivery through a hotline on knowledge and behavior outcomes.
Abstract submitted by:
Sacha St-Onge Ahmad - University of Maryland
Mustafa Naseem - University of Michigan
Shan Randhawa - New York University
Muhammad Bilal Saleem - New York University
Tallal Ahmad - Lahore University of Management Sciences
Agha Ali Raza - Lahore University of Management Sciences
High mobile phone ownership in Pakistan offers a unique opportunity to connect populations that otherwise would not have access to one another. We propose an Interactive Voice Response Service (IVR) to connect gynecologists to expectant fathers, a subgroup that is often the primary decision-maker at home. We developed and piloted Super Abbu (Super Dad), an IVR that delivers maternal health information in Pakistan. Its main features are: 1) a question and answer section that connects users to gynecologists and 2) a story-sharing section that allows users to share experiences with peers. Content is moderated prior to becoming public and can be shared with friends, commented on, voted on, and given open-ended feedback on by users. Findings include: 1) targeted robocalls result in high uptake and audio banner ads on existing IVRs result in high engagement and retention; 2) there is demand for maternal health information by men; 3) there is high approval of a service that delivers culturally sensitive information on reproductive health; 4) content moderators require guidelines on what questions to make public to maintain cultural appropriateness of the service; 5) content moderators require guidelines to prevent the spread of misinformation while protecting users' right to free speech. Super Abbu demonstrates that IVRs can: 1) collect data on the informational needs of marginalized populations about culturally sensitive topics and 2) deliver personalized information to hard-to-reach populations with low education levels. Limitations include limited information on users and health impacts of the service.
Background/Objectives:
High mobile phone ownership in Pakistan offers a unique opportunity to connect populations that otherwise would not have access to one another. We propose an Interactive Voice Response Service (IVR) to connect gynecologists to expectant fathers, a subgroup often excluded from maternal health programs. Informational interventions to promote maternal health-seeking behaviors have better impacts when they include male partners (Tokhi et al., 2018), and this is particularly true in cultures where men are often primary decision-makers, as is the case in Pakistan. We developed and piloted such a service, called Super Abbu (Super Dad), in Pakistan in 2018.
Description of Intervention and/or Methods/Design:
Super Abbu is an IVR that delivers maternal health information over a phone call. Its two main features are: 1) a question and answer section (Q&A) that connects users to gynecologists and 2) a story-sharing section (Stories) that allows users to share experiences with peers. In Q&A, questions are recorded by users, answered by doctors through a mobile application, and recorded by the persona of a female gynecologist. This feature allows users to receive personalized health information in addition to listen to Q&As other users have made public. In Stories, users listen to and record stories about pregnancy and childbirth. Content (Q&As and stories) is moderated prior to becoming publicly available and can be shared with friends, commented on, voted on, and given open-ended feedback on by users. Super Abbu was advertised through robo-calls, audio banner ads on a telephony service, radio, television, Facebook, and flyers.
Results/Lessons Learned:
The 71-day deployment yielded 21,500 users who made 40,000 calls, recorded 11,000 questions, stories, comments and feedbacks, shared content 5,000 times and voted on content 31,000 times. Findings include five lessons learned for deploying a maternal health hotline targeted at men in Pakistan: 1) targeted robocalls lead to high uptake and audio banner ads on existing telephony services result in high engagement and retention; 2) there is high demand for maternal health information by men; 3) there is high (but not total) approval of a service that delivers culturally sensitive information related to reproductive health; 4) content moderators require guidelines on what questions to make publicly available (versus privately available to users who recorded the question) to create and maintain cultural appropriateness of the service; 5) content moderators of user-generated stories require guidelines to prevent the spread of misinformation while protecting users' right to free speech.
Discussion/Implications for the Field:
The pilot resulted in several implications for the development and deployment of a service that connects groups of people that lack access to each other. Super Abbu demonstrates that IVRs can be used to: 1) collect data on the informational needs of marginalized populations about culturally sensitive topics and 2) deliver personalized information to hard-to-reach populations with limited literacy, numeracy and technological skills. Limitations of this pilot include not being able to collect sociodemographic information on all users or draw conclusions about the impact of health information delivery through a hotline on knowledge and behavior outcomes.
Abstract submitted by:
Sacha St-Onge Ahmad - University of Maryland
Mustafa Naseem - University of Michigan
Shan Randhawa - New York University
Muhammad Bilal Saleem - New York University
Tallal Ahmad - Lahore University of Management Sciences
Agha Ali Raza - Lahore University of Management Sciences
Source
Approved abstract for the postponed 2020 SBCC Summit in Marrakech, Morocco. Provided by the International Steering Committee for the Summit. Image credit: University of Michigan