Village Baby Care uses interactive voice response technology to deliver well-crafted, pre-recorded, and age-specific messages to new parents in rural Cambodia.
NGOs and the Role of Collaborative Innovation in Increasing Quality of Life Metrics
The drastically improved maternal, neonatal, and infant mortality rates in Cambodia are due in large part to the collaborative and innovative work of non-government organizations (NGOs). One such NGO, People in Need (PIN), is based in the Czech Republic and has over 20 international missions worldwide. PIN has worked in Cambodia since 2006.
Life Expectancy on the Rise in Cambodia; Maternal and Infant Mortality Rates in Rapid Decline
In the last 20 years, the estimated maternal mortality rate (MMR) in Cambodia has improved quite significantly. In 1995, the MMR per 100,000 births was 860. In 2013, the MMR was down to 170.
Additionally, survival rates of infants and children are increasing. In Cambodia, the neonatal mortality rate (i.e., the number of deaths in the first 28 days of life per 1,000 live births) was 17.6 in 2013, down from 38.5 in 1995. Similarly, the infant mortality rate (i.e., the number of deaths in the first year of life per 1,000 live births) has decreased from 101 in 1995 to 32.5 in 2013.
Although the quality of life for Cambodian’s has improved over the last several years, many Cambodians – especially the roughly 80% that live in rural areas – continue to face significant barriers to healthcare and health education.
Caring for a Baby Takes a Village
PIN worked alongside a Cambodian NGO, Reproductive and Child Health Alliance (RACHA) and 17 Triggers, a Cambodian-based group of behavior change and communication specialists, to develop Village Baby Care. The mHealth program uses telephones to deliver informative content about the first month of life to infant caregivers. PIN trialed the applications, and is ready to expand its reach to the central Cambodian province of Kampong Chhnang.
Midwives at local health centers play an important role in referring new parents and caregivers to the service. Additionally, word-of-mouth referrals encourage parents to register.
To set up the service, users enter the baby’s date of birth and choose a convenient time of day to receive voice messages via a phone. A recent study found that almost 94% of Cambodia’s population claims to own a phone, and 99% of the population is reachable by some sort of phone.
Village Baby Care was created in partnership with Verboice, a leader in interactive voice response (IVR) technology. IVR allows computers to interact with humans through the use of voice, virtually eliminating the reliance on literacy of text messaging.
Three days after birth, the parents receive the first 60-90 second message about their baby’s health and development. Additional messages are sent every three days.
Core health education messages include: umbilical cord care advice, the benefits of exclusive breastfeeding, effective breast feeding techniques, proper postnatal care, how to regulate baby’s body temperature, recognizing signs that the baby may be in danger, and risk behavior avoidance.
All messages remind parents and caregivers to take their babies to the health center if they suspect anything is wrong.
The messages are in line with the Ministry of Health’s Safe Motherhood Protocols, but delivered by fictional characters deemed influential in Cambodia. Three of the characters are female: a midwife, a village health volunteer, and a grandmother. Two are male: a doctor and a village chief.
All Users Surveyed After Trial Were Satisfied
Following the initial Village Baby Care trial, PIN’s user survey found that the neonatal mHealth program was both feasible and accepted by its intended audience. The survey results revealed that the timing of the messages was convenient, users believed the content of the messages, and many mothers adopted the newborn care practices as a result of listening to the pre-recorded guidance.
All participants were satisfied with the program, and 45% reported learning something new. Significantly, nearly 43% said they visited a health center as a result of listening to the messages.
Ly Vanny, a midwife at Kampong Tralach Leu Health Centre, refers her patients to Village Baby Care.
She says: “mothers are always keen to learn more about how to take care of their babies.”
Jenn Lonzer has a B.A. in English from Cleveland State University and an M.A. in Health Communication from Johns Hopkins University. Passionate about access to care and social justice issues, Jenn writes on global digital health developments, research, and trends. Follow Jenn on Twitter @jnnprater3.