Utilizing Group Cellphones to Promote Healthy Practices
The increasing proliferation of cellphones in Africa brings an opportunity to leap-frog off technological development to innovative mobile interventions. Our case study takes place in Nigeria, with a cellphone proliferation rate of 89%. MHealth is an innovative approach towards the integration of technology and health interventions. However, mHealth is limited for those without cell phone access; generally the most vulnerable like women in rural communities or the illiterate (40.4% of the population over the age of 15 cannot read and write in Nigeria). Therefore, Partners for Development and Dr. Valerie L. Flax, with her team of researchers from the University of North Carolina, provided groups of women with cellphones to research their effectiveness in disseminating and encouraging vulnerable populations to adhere to recommended health practices.
The researchers targeted women-microcredit clients. These women had received small loans and were already integrated into a group dynamic with other microcredit clients where peer support and accountability was highly valued for microfinance program success. Further, PfD’s intervention utilized the pre-existing small groups of women-microcredit clients for the purpose of our health promotion program; by linking social networks together with health information via text and voice messaging we are able to encourage communication and behavior change. The research found that integrating group counseling and cell phone messaging increased the likelihood of women to adhere to breastfeeding recommendations.
Dr. Flax performed a second round of research to analyze the feasibility and acceptability of group cellphones used to promote optimal breastfeeding practices for women’s microcredit groups within Nigeria. During this research, in each microcredit group, one woman was provided a low-cost cell-phone that received text/voice messages weekly on breastfeeding information. The woman responsible for the cell phone was asked to disseminate the information to her group within a week
Key findings from the target group (195 microcredit clients whose babies were born during intervention) include:
- 68% of the time, breastfeeding messages were usually shared in the small groups rather than individually
- 44% of groups met at least once a week to discuss the breastfeeding messages
- 59% of the small groups performed songs and dramas about the breastfeeding messages every week
- 58% of women trusted the messages and were motivated to try recommended practices
- 64% said the group phone worked well or very well
- 35% felt they had the support to carry out the breastfeeding recommendations
With regards to the feasibility and acceptability of providing a single cell phone to a group, focus group discussions showed unanimous neutral or positive feelings towards the single cell phone holder. Reports also show the information was shared promptly. Moreover, women continued to share what they learned about breastfeeding to their family and friends. In congruence with prior research, women in the target group who met at least once a week were more likely to exclusive breastfeed in comparison to women who never met with their group. As we can see, utilizing mobile health promotion in a group setting is a feasible, acceptable and worthwhile approach.
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In conclusion, despite Nigeria’s high cellphone penetration rate, women tend to have less access to cellphones and thereby mobile health promotion technology. Therefore, this tactic of targeting women who already have group dynamics formed within their microcredit program was effective in promoting optimal breastfeeding practices through the use of a group cell phone. This research is groundbreaking in exemplifying the feasibility of integrating mobile health technology into groups of the most vulnerable peoples.
At PfD, we are dedicated to delivering local solutions with sustainable outcomes. As seen in this exemplified program, women and children are at the forefront of our programming. Learn more about PfD’s work promoting lifesaving and cost-effective recommended maternal health practices in our blog, http://pfd.org/building-on-the-microcredit-platform-for-better-child-health/. And read more about our work in Nigeria with maternal health here http://pfd.org/the-question-of-quality-comprehensive-respectful-and-rights-based-maternal-health/
Flax V.L., Negerie M., Ibrahim A.U., Leatherman S., Daza E.J. & Bentley M.E. (2014) Integrating group counseling, cell phone messaging, and participant-generated songs and dramas into a microcredit program increases Nigerian women’s adherence to international breastfeeding recommendations. The Journal of Nutrition 144, 1120-1124