Delivering Maternity Health Support with TextIt: A Case Study

ProGobernabilidad, a Canadian Ministry of Foreign Affairs, Trade and Development initiative to empower the women and children of Northern Peru through various ICT4D approaches, recently completed a study measuring the effectiveness of a 2-year maternity health program pilot they conducted using TextIt. We spoke with e-government specialist Réjean Roy about the project.

Parameters

In 2012, the ProGobernabilidad project was developed around 3 vital facts:

  • In 2012, less than 18% of the people of Lambayeque, the region in which the 6 participating medical clinics are located, had home internet access.

  • That percentage was close to 0% in the rural areas of Lambayeque. While community members can visit cabinas to access the internet, they’re largely inaccessible. Price and lack of technical expertise are barriers to internet access in the region. As a result, less than 30% of all Peruvians living outside Lima and only 10% of Peruvians living in rural areas used the Internet in 2012.

  • A large portion of the Peruvian population has access to basic feature phones. In Lambayeque, for example, over 85% of people live in a house where at least one person owns a mobile phone.

It became clear to Réjean and his colleagues that mobile phones are the most suitable channel to deliver services electronically to the community of Lambayeque.

Methodology

Determined to reduce the child mortality rate and strengthen the first 1,000 days in the continuum of care for mothers and their children, the e-government team set out to pilot a maternity reminder system modeled after the Mobile Alliance for Maternal Health (MAMA) program, which has been deployed in 70 countries worldwide.  

Following a comprehensive search for the right mobile-based communication platform, Réjean chose TextIt, which he discovered through a course offered by TechChange. “I had looked at other tools when I started this process, but what really impressed me is that yours is a lot easier to use than the others.”

TextIt’s instinctual Flow Engine enabled Réjean to swiftly build a sample Campaign to demonstrate to the IT team in Peru. His colleagues then harnessed TextIt’s API to integrate their medical records software, allowing TextIt to submit information to and request information from their external medical records application.  

In November 2013, ProGobernabilidad launched its pilot program with 250 women across 6 Lambayeque clinics. “The demand is very, very strong…the mothers and their families really love it,” says Réjean.

End-User Onboarding

ProGobernabilidad provided a series of trainings for nurse-midwives and pregnant women and their companions on the functionality of the SMS system they built with TextIt. In addition, they extended recruiting responsibilities to nurse-midwives and doctors. At TextIt, we refer to this as end-user onboarding. This is important. If end-users don’t understand how to interact with your application, or how and why interacting with your application benefits them, they’re less likely to respond correctly and complete your Flows.

End-user onboarding can be time-intensive and require patience. It took ProGobernabilidad nearly a year to sensitize and capacitate pregnant women to use their TextIt SMS system.

Flow Methodology

ProGobernabilidad took advantage of TextIt’s Campaigns feature to schedule a series of Flows comprised of maternity reminder messages. Watch the video below for a short, visual explanation of this process:

Results

ProGobernabilidad conducted a pilot study to assess the effectiveness of the program.

Some highlights from the study include:

  • Pregnant women who participated in the program attended a greater number of prenatal checkups at the end of the 16th week of receiving the messages.

  • Pregnant women who participated in the program had higher chances of having an institutional delivery at the end of the program.

  • Mothers who participated in the program reported more consistent breastfeeding at the end of the 16th week.

  • Nurse-midwives revealed that the program improved their capacity to counsel the pregnant women.

Lessons Learned

  • Nurse-midwives interviewed for the pilot study suggested that more focus be placed on training pregnant women and their companions to be successful with the program so that they might offer their testimonials and disseminate the system within their community. They also suggested that ProGobernabilidad advertise the program with posters, billboards and flyers.

  • The study failed to secure follow-up interviews with the majority of mothers who had graduated from the maternity health program, as the phone numbers were either disconnected or the mothers had changed carriers. In economically underdeveloped regions, users are more likely to jump from carrier to carrier to take advantage of deals. It’s advisable to account for this behavior when designing your TextIt SMS application and the program in which it will be implemented.

Moving Forward

One of ProGobernabilidad’s long-term goals is to demonstrate to the government of Peru that providing services via mobile phones is a mutually beneficial endeavor.

On the heels of a successful pilot, ProGobernabilidad is preparing to expand their presence from 6 clinics to more than 20 by including the Tumbes and La Libertad regions.

Sign up for a TextIt account today to start building your own SMS application. In keeping with our goal of fostering development, we provide 1,000 complimentary credits to every new account, as well as country-specific guides to integrating with local carriers and international gateways.

We understand that flexibility is key when deploying an SMS or IVR application, and that’s why we offer a simple prepaid model that lets you add credits to your account only as you need them.

To learn more about TextIt, visit our Learning Center, review our documentation, or watch this short video: