MOBILE KUNJI : An AID For Frontline Workers

State and Development Partner

Bihar

The Bill & Melinda Gates Foundation, BBC Media Action 

Problem

Family planning, child-care, birth preparedness, and complementary feeding are examples of the many issues a frontline workers (FLW) — both Accredited Social Health Activists (ASHA) and Anganwadi Workers (AWW) — tackles every day as she counsels women in her village. But the effectiveness of these messages is dependent entirely on the FLWs' communication skills, which are bound to vary person-to-person, leading to inconsistent message delivery. Additionally, FLWs may not have appropriate educational materials that can be taken door-to-door to reinforce their messages. FLWs are members of the communities they work in, and often struggle to be taken seriously. Families tend to view them as just another neighbour as opposed to an informed and trained worker who can guide them appropriately. Under these circumstances, how can an FLW ensure her messages are being understood and practised?

Conventional Solution

FLWs either go for home visits or attend to women at the Anganwadi Centres (AWCs) to educate them on reproductive, maternal, neonatal and child health. They talk to women who seek their advice and hope that their messages translate into action. Counselling is certainly important, but the method could use an upgrade. Conventionally, FLWs have been given paper-based tools such as flipcharts or flashcards to support their counselling. These tend to be bulky for FLWs to carry because they might have to address multiple thematic areas each day, and therefore, need to carry a vast amount of communication material with them. Paper-based materials are not user-friendly: they tend to require a high degree of literacy, and do not always survive the extreme weather conditions that FLWs in Bihar have to deal with. FLWs have widely varying skills, experience and abilities. They are educated to a high school level, at best, and often struggle with competing priorities, both at work and at home.

Behavioral Insights Based Solution

Mobile Kunji is a multi-media job aid (Kunji means key or guide in Hindi) designed for use by FLWs when they counsel families. It has two components: a deck of colour-coded cards with illustrations and related key messages for each stage of pregnancy or post- natal care, and an audio component accessed via mobile phone. The cards have been designed to look like a mobile phone, with illustrations, supporting arguments and key messages. Each card carries a unique, seven-digit number or mobile shortcode that the FLW dials from her mobile phone, playing a piece of pre-recorded audio content for the family she is visiting. The audio content is delivered in the voice of a fictional doctor character, Dr. Anita, who brings credibility along with her great and very localised bedside manner. Mobile Kunji helps standardise the FLWs’ delivery of the key messages, reducing inconsistency and significantly improving interpersonal communication. The use of a doctor representation leverages the ‘messenger effect’, i.e., when individuals make their decisions based on who is giving the message and the perceived credibility of it's source. This lends authority to the FLW in her interactions with families.

Impact

Evidence shows that conversations between FLWs and families last twice as lonp when Mobile Kunji is used, and families trust FLWs who use Mobile Kunji more than those who do not. Families are 1.6 times more likely to adopt contraception to limit the size of their family compared to those not exposed to the tool. Those exposed to Mobile Kunji were almost twice as likely to prepare appropriately for childbirth and 17% more likely to feed their children solid or semi-solid foods at the ripht ape.

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