Can information delivered on a mobile phone affect the outcome of a pregnancy in a developing country?  Can communities and healthcare workers use mobile phones to save the lives of newborns?  These are some of the questions that the Mobile Technology for Community Health (MOTECH) program in Ghana is trying to address.  Grameen Foundation is working with Ghana Health Service and Columbia University in one of the poorest rural districts of Ghana to try to improve the health outcomes for mothers and their newborns using mobile phones.  But once a service has been created, how do you generate awareness for it and ensure there is adequate participation?

In July 2010, we launched a service called “Mobile Midwife,” which enablespregnant women and their families to receive SMS or pre-recorded voice messages on personal mobile phones.  The messages are tied to the estimated due-date for the woman so the information is time-specific and delivered weekly in their own language.  Nurses also use mobile phones to record when a pregnant woman has received prenatal care.  If critical care is missed, both the mother and the nurse receive a reminder message on their mobile phones.  To date, over 7,000 pregnant women and children under five have been registered in the system.  More detail about the program can be found online in our “Lessons Learned in Ghana” report.

One of the challenges we faced in the development of this system was how to generate awareness for the “Mobile Midwife” service in the first place.  Unless people register for the service, they cannot receive the important information we are able to provide about pregnancy.  As we talked to people in the rural villages where “Mobile Midwife” would be available, it quickly became clear that communities in Ghana, and particularly the Upper East Region, had been inundated with cartoon-like health message campaigns from myriad NGOs and government agencies.  People told us that if campaigns were seen as “too slick,” people would not think the messages were relevant to them.  The MOTECH team decided to pursue an approach that sought to provide “aspirational” images that were differentiated from the typical “NGO cartoon” campaign, but still were relevant to the UER population.  This included using real photographs instead of drawings, and ensuring that the people in the photographs were wearing clothes in the style of those worn in the rural areas where we worked.  Part of the aspirational message was dressing the models in new, clean clothing, which proved to be effective.  When field testing the marketing styles, many people said they “liked the lady in the pictures and it made them feel good as one day they would like to be dressed well too.”  The team also decided to create some messaging that was targeted specifically to men, in an effort to respect their roles as decision makers in the family, get them to listen to the messages with their partners, and be a part of making positive health choices throughout pregnancy, birth and early childhood.  As the program evolves, we expect to experiment with broader reach marketing vehicles such as radio and community mobilization.