Key learnings from an outcome and embedded process evaluation of a direct to beneficiary mobile health intervention among marginalised women in rural Bihar, India

• Published in: BMJ open 2022-10, Vol.12 (10), p.e052336
• Main Authors: Irani, Laili, Verma, Supriya, Mathur, Ruchika, Verma, Raj Kumar, Mohan, Diwakar, Dhar, Diva, Seth, Aaditeshwar, Chaudhuri, Indrajit, Chaudhury, Mahua Roy, Purthy, Apolo, Nanda, Ankit, Singh, Shivani, Gupta, Akshay, LeFevre, Amnesty Elizabeth
• Format: Article
• Language: English
• Subjects: Beneficiaries; Child; Children & youth; Childrens health; Data collection; Diarrhea; EDUCATION & TRAINING (see Medical Education & Training); Families & family life; Family planning; Female; Global Health; Households; Human resource management; Humans; India; Infant; Knowledge; Lactation; Maternal & child health; Meetings; Mothers; Nutrition; Pregnancy; Rural areas; Rural Population; Self help; Source studies; Support groups; Telemedicine; Women
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2021-052336

IntroductionMobile Vaani was implemented as a pilot programme across six blocks of Nalanda district in Bihar state, India to increase knowledge of rural women who were members of self-help groups on proper nutrition for pregnant or lactating mothers and infants, family planning and diarrhoea management. Conveners of self-help group meetings, community mobilisers, introduced women to the intervention by giving them access to interactive voice response informational and motivational content. A mixed methods outcome and embedded process evaluation was commissioned to assess the reach and impact of Mobile Vaani.MethodsThe outcome evaluation, conducted from January 2017 to November 2018, used a quasi-experimental pre–post design with a sample of 4800 married women aged 15–49 from self-help group households, who had a live birth in the past 24 months. Surveys with community mobilisers followed by meeting observations (n=116), in-depth interviews (n=180) with self-help group members and secondary analyses of system generated data were conducted to assess exposure and perceptions of the intervention.ResultsFrom the outcome evaluation, 23% of women interviewed had heard about Mobile Vaani. Women in the intervention arm had significantly higher knowledge than women in the comparison arm for two of seven focus outcomes: knowledge of how to make child’s food nutrient and energy dense (treatment-on-treated: 18.8% (95% CI 0.4% to 37.2%, p