Embedding Evaluation into m. Health Activities: Opportunities and Challenges Kelly Ladin L’Engle, Ph. D, MPH Behavioral and Social Sciences FHI 360 m. Health Working Group Meeting: Innovative Monitoring and Evaluation of m. Health, October 20, 2011
We need more evaluation! • While m. Health has great potential, current research…does not provide much evidence ror actual and wide-scale health impacts, nor answers to critical research questions…. (Mechael et al. , 2010)
m. Health M&E Opportunities • Real-time data, and lots of it • Ability to automate systems • Increased and additional access to program users Two examples: 1. m 4 RH (Mobile for Reproductive Health): opt-in, menu-based, pingpong, SMS system providing information about 9 family planning methods and clinic locations in Kenya and Tanzania 1. ECINFO: Randomized controlled trial testing timed delivery of family planning role model stories to emergency contraception users, compared to m 4 RH access, and control group in Ghana
Example: Monitoring User Data from m 4 RH Keyword Content m 4 RH # of queries Kenya Tanzania Main Menu 6787 4333 Secondary Menus 7995 3135 11 Implants 1520 685 21 IUDs 1319 650 31 Permanent Methods 1084 620 41 Injectables 1467 671 51 OCPs 1492 598 61 Emergency Contraception 1408 1020 71 Condoms 2199 748 81 Natural Methods (incl. LAM in Kenya) 3170 1362 91 Clinic Locations 1281 813 29, 722 14, 635 00, 01, 02, 03, 99 Total Hits
Example: Automated Systems for ECINFO
Example: Increased Access to m 4 RH Users Purpose Text Introduction Thanks for using m 4 RH! Please help us with 4 questions and stand a chance to win FREE air time. M 4 RH is free, voluntary, and confidential…You can use m 4 RH even if you don’t answer these questions. You will receive the questions shortly. . . Please tell us your gender. Reply F if you are female, M if you are male, and send to 4128. Which is true for you? If you are 19 or younger reply A; If 20 -29 reply B; If 30 -39 reply C; If 40 or older reply D. Gender Age How did you learn about m 4 RH? From a clinic, reply R; partner, friend or family member- S; community health or peer educator- T; community event. U; radio- V. Associated KAB How has m 4 RH changed your use of family planning? Reply CHANGE then your change, like ‘CHANGE got an IUD’. Change Promotion Point Reminder Hello from m 4 RH, this is a friendly reminder to please help by answering the 4 questions sent to you earlier this week. You still stand a chance to win.
Open-ended Texts m 4 RH • Started using condom with my partner • Protected me from early pregnancy • Got to know clinics in my region hence access of services easy and from a reliable source • Got IUD that has helped me manage my only two kids with my little monthly salary from casual jobs • Use 3 -month injections enjoy sex like never before • Got implant for wife
Example: Additional Access to m 4 RH Users 1. Continuous electronic data capture and monitoring 2. Fielding of text questions to m 4 RH users to assess age, gender, where they learned about m 4 RH 3. Potential for pre-post data collection to assess change in use of family planning methods 4. Telephone interviews to obtain feedback on system, evidence for clinic referrals and FP uptake, and m 4 RH “intervention map” 5. Clinical-level data collection to assess if clients visit clinic as a result of m 4 RH 6. Future: Conduct rigorous experiment or quasi-experiment to assess m 4 RH impact
M&E: New Methodological Challenges • Analysis issues • Response rates • Limits on SMS data collection: – Question format and order – Data validity and reliability – Amount of data that can be collected • Participant recruitment and study consent • Etc.
CONTACT Visit our m 4 RH website: www. fhi. org/m 4 RH Kelly L’Engle klengle@fhi 360. org 919 -544 -7040 10
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