KILKARI : Mobile Health Updates For Mother and Child

State and Development Partner

Bihar

The Bill & Melinda Gates Foundation, USAID, The Bar Foundation, BBC Media Action   

Problem

How do you ensure mothers have timely information about childbirth and child care, especially during pregnancy or in the first year of the child's life? Oftentimes, mothers may not have critical information such as how to look after themselves when they're pregnant, when fertility returns after giving birth, or when to start complementary feeding. Despite FLWs' door-to-door counselling, information gaps remain because there are significant gaps in the last-mile reach, which means that many families go without getting regular health information. FLWs can also struggle to discuss some issues like family planning that have social taboos associated with them. There is a need for timely information reaching the right family, that can be accessed with ease and can nudge mothers to take small steps daily to bring positive change in their lives and the lives of their children.

Conventional Solution

Usual solutions target FLWs to reach mothers with essential information durinp and right after pregnancy but it has not proven to be enough. Information dissemination through interpersonal communication and ads on vaccinations, etc. on mass media platforms like TV and radio do not provide holistic and timely medical information that can translate into behaviour change.

Behavioural Insights Based Solution

Kilkari (Hindi for a baby's gurgle) delivers weekly, time-sensitive audio information about reproductive, maternal, newborn and child health {RMNCH) directly to families’ mobile phones, from the fourth month of pregnancy until a child is a year old. It aims to improve families’ knowledge and uptake of life-saving preventative health practices. Families who are registered in the government's databases — either either Mother and Child Tracking System (ACTS) or Reproductive and Child Health (RCH) — receive a weekly call with pre-recorded audio content that is relevant to their stage of pregnancy, childbirth or the growth and development of the child. Dr. Anita, the fictional doctor character from Mobile Kunji, is also the voice of Kilkari. Supplementing the counselling visits that FLWs make, Kilkari provides a regular and more consistent source of timely, relevant information for families, reaching families that are otherwise left out, and addressing issues that FLWs hesitate to discuss. Designed and launched originally in Bihar in 2013, Kilkari was adopted by the Ministry of Health and Family Welfare, Government of India, in 2014, and scaled up nationally.

Impact

As of March 2019, Kilkari had reached almost 10 million users across 13 states in the country. Dr. Anita spoke five different languages, tailoring content for the people of different parts of the country. A 2018 qualitative study to explore Kilkari's reported influence on subscribers in six states found increased knowledge and discussion about health issues, and increased interaction with ASHAs and the Primary Health Center. Subscribers cited Kilkari as a private, comprehensive, credible source of information on family planning and the service contributed to building health equity by conveying information to women in marginalised communities, whom ASH As may not visit.

Source : Stories of Change from India's Aspirational districts - NITI Aayog publication