Mama Report

8/11/2019 Mama Report

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SPARKING A GLOBAL MOVEMENT WITH MAM


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MAMA would like to thank its global parters the U.S. Agency for Internaonal Development,

Johnson & Johnson, UN Foundaon, mHealth Alliance, and BabyCenter for making its work

possible. In parcular, MAMA would like to express its gratude to BabyCenter and their

amazing internaonal editorial team: Daphne Metland, Anna McGrail, and Gayatri Koshy, for

creang MAMA adaptable messages and guidelines.

Addionally, MAMA would like to acknowledge the contribuon of its Health Content Advisory

Board: Dr. Mitchell Besser, Founder and Medical Director, mothers2mothers; Valerie DeFillipo,

Director, Family Planning 2020; Hamid Rushwan, Chief Execuve, Internaonal Federaon of

Gynecology and Obstetrics; Judith Palfrey, Professor of Pediatrics, Harvard Medical School;

Ann Jimerson, Senior Specialist in Behavior Change, FHI360; Jane Morgan, Head of Midwifery

Educaon and Lead Midwife for Educaon, Edgehill University; Professor Christa van der

Walt, Associate Professor School of Nursing, North-West University; and Hayalnesh Tarekegn,

Program Ocer, United Naons Children Fund (UNICEF) who generously gave their me and

experse to developing these messages. This body of work would not have been possible

without the cooperation of many partners, including Every Woman, Every Child, UNICEF APromise Renewed, MDG Health Alliance, MCHIP, FHI360, M4RH and many others.

...................

Special thanks to BabyCenter, a member of the J&J family of companies, for its generous contri-

buons and experse in MAMA content development.

ACKNOWLEDGEMENTS


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The Mobile Alliance for Maternal Acon (MAMA) founded by USAID, Johnson & Johnson,

mHealth Alliance, UN Foundaon and BabyCenter is an innovave public-private partnership

that supports programs delivering vital health informaon through mobile phones to mothers inlow-resource sengs across the developing world.

Many of the simple health intervenons that have been proven to reduce maternal and child

deaths begin within the household. Birth spacing, regular antenatal care, exclusive breaseeding,

handwashing, use of inseccide-treated bed nets to prevent malaria all are behaviors that

require the knowledge and willing parcipaon of the mother, and other household and commu-

nity decision-makers.

Mobile phone-based health messages are portable, accessible, discreet and can be saved or

shared. They can provide informaon, oer support, dispel myths, highlight warning signs and

connect pregnant women and new moms with local health services. Messages can be targeted

to a womans stage of pregnancy or the age of her child so that the informaon reects exactlywhat she is experiencing at a parcular me. This helps to build an emoonal connecon with

the mother and a sense of trust, making it more likely that she will be recepve to messages

that encourage changes in behavior. The messaging program accompanies each mother on her

journey of learning and discovery, and acts as a step-by-step guide to a healthy pregnancy and

healthy baby.

Photo:MobileAllianceforMaternalAcon

THE MOBILE ALLIANCE FOR MATERNAL ACTION


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MAMA Adaptable Messages

MAMA directly supports mobile messaging

programs in Bangladesh, South Africa, and India,

and then uses this praccal experience to inform

the design of tools and resources to help other

like-minded organizaons accelerate the launch

of their own systems creang a mulplier eect.

The rst MAMA resource has been a set of free,

adaptable mobile messages. The set contains core

messages for pregnancy and the rst year of a

childs life, plus messages on specic health topics

like infant feeding, prevenon of mother-to-child

transmission of HIV, and post-partum family

planning.

The messages come in two formats: text messages

designed to be sent three times a week, and

voice messages designed to be sent once a week.They were developed by BabyCenter using their

stage-based mode and tone, in partnership with

a team of experts in maternal, newborn, and child

health. They have been rigorously researched

and reviewed to ensure that they reect the

latest internaonal evidence and best pracces.

The adaptable messages serve as a guide to

recommended topics, tone, and ming so that

organizaons can quickly create messages appro-

priate for new and expectant mothers in their

local seng. MAMA also provides adaptaon

guidelines to further aid in the localizaon process

and to opmize the emoonal connecon needed

for behavior change.

A growing MAMA community

In less than two years, over 230 non-prots,

social enterprises and governments in almost

60 countries around the world have joined the

MAMA community by downloading and using

the evidence-based, mobile-formatted MAMAmessages. The messages currently reach more

than 530,000new and expectant mothers globally.

NUMBER OF ACTIVE ORGANIZATIONS

1 2-5 6-10 11-20 21+


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The Liga Inan (Mobile Moms) project is using

mobile phones to connect expectant mothers withhealth care providers in Timor-Leste to improvethe likelihood of a healthy pregnancy and birth.

Funded by USAIDs Child Survival and Health GrantsProgram, Liga Inanis implemented by Health AllianceInternaonal (HAI) and Catalpa Internaonal, in part-nership with Timor-Lestes Ministry of Health (MOH).

Many women in Timor-Leste live in remote andrural areas, which makes it challenging for themto access health facilies and midwives. Liga Inansends maternal health-related text messages twiceweekly to pregnant women, who are enrolled inthe project by midwives at the me of their rstantenatal visit. The system also sends messages tomidwives to encourage phone contact with pregnantor postpartum women, especially around the me ofdelivery.

USING THE MAMA MESSAGESThe MAMA adaptable mobile messages were trans-lated into Tetum, the local language, and edited to160 characters to t within a single SMS. Messageswere chosen to align with the priories of the MOHand address the needs of the rural populaon. Themessages were reviewed in stakeholder meengswith the MOH at both naonal and district levels.Pregnant women in the project area were enrolledin further pre-tesng to determine comprehensionand acceptability.

The messages emphasize aendance at antenatal

clinic appointments, using a skilled birth aendant,nutrion, birth planning, and danger signs in preg-

nancy, delivery and the newborn period. Messages

also address the postpartum tradion of tuurahi (literally, sitting fire) where the new

mother and newborn are sequestered in the

home for several weeks next to an open rebecause the heat is believed to have bene-cial healing eects. The messages includedinformaon on the harm of open re smoke tonewborns, with advice to prevent this.

PROGRAM SPECIFICSAn inial household survey showed that house-

hold ownership of mobile phones was high, textmessaging was common, and 73% of women couldread the local Tetum language.

Midwives use smart phones provided by the projectto enroll women into the Liga Inan service duringtheir rst antenatal care visit. The midwives receivetext reminders about women who are near theirdue date and are responsible for calling to check

their health status, discuss birth planning, or conrmwhether the woman has delivered. Midwives alsoanswer questions from pregnant or postpartumwomen and idenfy emergencies.

HAI decided on a phased rollout starng in thelargest and most densely populated subdistrict ofSame. Stakeholder meengs including village chiefs,health facility managers and other health sta,community health workers, teachers and pregnantwomen were carried out in communies throughoutSame to provide informaon on the service.

EVALUATION AND RESULTSLiga Inanwas launched in the last week of February2013 in the subdistrict of Same. It rolled out to twoaddional subdistricts in July and a nal subdistrictin August 2013. There has been a very enthusiascresponse to the project by both the health sta andthe communies they serve. In the rst six months,533 women have enrolled in Liga Inanand 221 birthshave been recorded among enrollees. Althoughit is too early to look at project impact, the data isencouraging. In the rst full month of Liga Inanimplementaon there were 56 births aended by askilled provider (average in 2012 was 38) and 38 deliv-eries at the health facility (average in 2012 was 27).

Over the rst six months of the program the

number of midwife-aended births has beenconsistently higher every month compared tothe months preceding the Liga Inan program.This is early in the project, however, and HAI sta willbe working hard over the next year to assure dataquality and eecve monitoring of the project.

Learn more at www.ligainan.org

MAMA COMMUNITY SPOTLIGHT

TIMORLESTE

Photo:ManueladeCosta

T-shirts and caps with the Liga Inan logo and tagline,

Your health is in your hands were distributed to

project sta, health sta and community health workers

to promote the project.


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How MAMA messages are addressing specic health challenges


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Extending to one to three yearolds: new child mobile messages

Building on the success of its pregnancy and baby

messages, MAMA recently announced a new

mobile message oering: MAMA Child Messages.

The free and mely text and voice messages

allow a mother to connue receiving messageson her cellphone up to her childs 3rd birthday,

covering topics on how to best care for her child,

including nutrion, hand washing, and vaccina-

on. Messages will also include informaon on

how to prevent pneumonia, diarrhea and malaria,

the three largest causes of death in children under

ve years.

Sample messages:

The Child Messages can be easily combined with

the MAMA core pregnancy and baby messages

for delivery over the course of pregnancy, infancy,

and ages 1-3 (43 months of messages!). These

messages were developed by BabyCenter, a

member of the J&J family of companies, in part-

nership with MDG Health Alliance, GBC Health,

and UNICEF in support of the Every Woman, Every

Child and A Promise Renewed iniaves.

Stages of implementaon

In addion to preparing suitable content, imple-

menng a successful mobile messaging program

requires several steps, including: dening the

target audience; selecng a suitable technology

platform for message delivery; user testing;

obtaining government and regulatory approvals;

markeng to potenal users; and monitoring

and evaluaon. A survey of MAMA community

members (n=57) asked organizaons to describe

their current stage of implementaon. Just over

half reported that they have begun a messaging

program, or are poised to start once early content

development, system design and user tesng is

complete.

MAMA tools and resources aim to support these

programs to transion from the inal start-up

phase to live programs by reducing barriers tosuccessful launch and scale-up.

*Messages will be used for research or comparison,

but will not form the basis of a live program

Creang new partnershipsand conversaons

The MAMA community convenes monthly for

an interacve online learning session around a

key implementaon issue, such as translang

and localizing content, selecng a technology

plaorm, or negoang with mobile network

operators. Representaves of each organizaoninteract through an online discussion forum and

can parcipate in working groups on specic

topics such as monitoring and evaluaon.

Already, new collaborations are beginning to

form representaves from Peru, the Dominican

Republic, Venezuela, and Colombia have recently

joined forces to translate the MAMA messages

into Spanish for use in Lan America.

Visit hp://mama.techchange-courses.org/ to join the

conversaon!

Wil

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*

Program

Sta

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tarted

19%

32%

12%

37%

Trust your insncts. If you think your child is unwell, takeher to the clinic. You know her beer than anyone else,so trust yourself.

Keep your child away from anyone who coughs andsneezes. Many illnesses are spread through coughs andsneezes, including pneumonia.

I downloaded the messages almost 8 months ago. We are establishing

a MAAN (MAMA) helpline and IVR system for our project. We translated the

messages into the local languages URDU and SINDHI for easy understanding

by the community... these messages are very helpful for us.

NISAR CHOUDARY, INTEGRATED HEALTH SYSTEM STRENGTHENING ALLIANCE


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MAMA mobile messages have been translated into 20 languagesMembers of the MAMA community have translated and adapted the MAMA mobile messages to suit

the parcular needs of their country and target audience. To date, the messages have been translated

into Bangla, Zulu, Xhosa, Sotho, Afrikaans, Tetum, Swahili, Urdu, Sindhi, Filipino, Portuguese, Chinese,

Pashto, Dari, Spanish, Luganda, Haian Creole, Dagbanli, Chichewa, Chiyao.

ina

Mother

manman

me

mama

umama

ma

mme

mata

madaar

mam

inan

maama

maau

MESSAGING PROCESS

REQUEST ACCESS AND DOWNLOAD

Organizaons visit the MAMA website, completean online applicaon, and login to download the core

messages and messages on specic health topics.

TRANSLATE, LOCALIZE, REVIEW, AND TEST

Organizaons adapt the MAMA messages in line withlocal priories, policies and cultural norms. Messages are

reviewed by local experts and tested with real moms.

DISTRIBUTE TO SERVICE SUBSCRIBERS

Organizaons select a technology plaorm formessage delivery, complete the system design, and

begin to enroll users.

MAMA SUPPORT

MOBILE-FORMATTED MESSAGES AND PARTNER NOTES

MAMA provides 140-character SMS messages and 1-minaudio scripts, with up-to-date refs. Messages are med by due

date or birth date to align with moms weekly experiences.

GUIDELINES, ONLINE LESSONS, IN-PERSON WORKSHOPS

MAMA engages an expert community to provideguidance on topics such as establishing an emoonal

connecon or dealing with sensive issues.

BEST PRACTICES, CASE STUDIES, HOW-TO GUIDES

MAMA provides examples from other successful programsto guide implementaon decisions, as well as targeted

support around specic challenges.

D O W N L O A D

A D A P T

S E N D

I have implemented a Maternal and Child health program in Eastern Ugandafrom 2009 2012 where I have lived and worked with poor families who

do not have access to health informaon. I used MAMA messages to equip them

with informaon that has helped them learn how to take care of themselves

during pregnancy. I am now in the process of translang these messages into

3 dierent languages to use them in 6 districts of Uganda... .

NALWEYISO OLIVIA MARY, TEXT TO CHANGE


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Coming soon: MAMA Aliate Package

Adaptable mobile messages are just the start. We realize that launching a successful mobile messaging

program requires much more, so based on requests from the MAMA community, MAMA will launch anew package of targeted support services to help aspiring country programs move more rapidly from

start-up to naonal scale.

MAMA is commied to the principles of local capacity building and open source soware development,

and will work in partnership with local country consora and experienced technology developers to

launch services that reach millions of mothers and their families with vital health informaon.

HOW TO GET INVOLVED Visit www.mobilemamaalliance.org to request MAMAs mobile messages,

download tools and resources, learn about MAMAs online community events, or sponsor a mother

through one of MAMAs country programs.

Living Goods operates networks of micro-entrepre-neurs who go door-to-door selling a wide range oflife-changing products, including treatments formalaria and diarrhea, fored foods, clean cookstoves, and solar lights. Networks of franchised

micro-entrepreneurs leverage Living Goods brand,buying power and markeng tools to deliver vitalproducts at accessible prices to the people who need

them most.

Simple phones are quickly becoming the singlemost transformave tool for Living Goods success.They have built a mobile plaorm designed to drivedemand, increase access, and reduce costs for deliv-ering products that save and change lives.

Living Goods is building a powerful client data-base across the regions they serve to date, theyhave over 35,000 registered cellphone numbersin Uganda. Theyre leveraging that database andthe speed and eciency of mobile to drive beer

health through services such as real-me treatmentreminders, community agents on call, and pregnancyand child care messages.

USING THE MAMA MESSAGESLiving Goods used MAMAs maternal health messagesto inspire a set of automated SMS messages forpregnant women and new mothers called theHappy Babyservice. Once enrolled by their agents,clients receive automated weekly stage- and age-ap-propriate SMS messages to encourage a healthypregnancy and delivery.

To support the agents on the ground and increase

their sales, the messaging service includes severalmessages with a clear call to acon, including the

name and mobile number of the clients agent.Living Goods integrates specic product recom-mendaons that support a healthy pregnancyinto the messages like iron and folate tablets,clean burning cookstoves, and safe deliverykits. These are all available through commu-nity agents.

Example: Dizziness, headaches, redness areall symptoms of low iron. Take a daily ironsupplement. Need iron? Call Living Goods(Nakamya Rebecca 0774862596).

The Happy Baby service also includes MAMAseducaonal messages on how to aain a healthypregnancy, and emoonally engaging messages tokeep clients interested in the service throughouttheir pregnancy and beyond.

In less than one year since the use of MAMA

messages began, more than 7,300 pregnant womenhave been registered.

CHALLENGESAt the program outset, texng was sll foreignto many agents. Living Goods provided intensive

training and an incenve scheme to drive adopon.In addion, many agents shared phones with theirfamily members and did not always carry them inthe eld making it dicult to register clients on thespot. In response, Living Goods oered their agentsnancing for a good-quality, low-price phone, andmore than 40% of agents bought one.

Learn more at http://livinggoods.org/

Photo:TineFrank

Nanyanzi Harriet, a Living Goods agent in Nsangi, Uganda,

with two of her clients. Harriet registered them both to

receive the Happy Baby SMS Service. Both appreciated the

service and are proud to show o their healthy newborns.

Nahura Sharon said it was like having a hospital at home.

MAMA COMMUNITY SPOTLIGHT

UGANDA


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For more informaon, visit: www.mobilemamaalliance.org

Contact us at: [email protected]

Follow us on Twier: @mamaglobal

Join us on Facebook: Mobile Alliance for Maternal Acon - MAMA Global

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