Interactive Voice Response (IVR) based health information for antenatal and postnatal care services in rural Bangladesh

Description of interventions using the TIDieR (Template for Intervention Description and Replication) Checklist Brief name/description: This is an interactive voice response (IVR) based health information trial where pregnant women in rural Bangladesh will be provided with information on evidence-based and recommended World Health Organization (WHO) guidelines and the guidelines of Bangladesh following the Ministry of Health and Family Welfare for prenatal and postnatal care services for expectant mothers and their newborn babies. Why?: Having evidence-based information on maternal and child care will improve maternal and child health outcomes in two ways: - by improving in knowledge on and practice of maternal and child health care, and - by improving maternal and child health care seeking What: Demonstration: One-hour session on how to access the information using IVR on a mobile phone. Materials: 15 modules containing pregnancy and postpartum stage-specific information on antenatal and postnatal care, antenatal and postnatal mental health, and taking care of a newborn baby for up to 6 months. The modules will be recorded in voice-over form and stored using IVR technology. Participants will be able to access this information any time they want. Tele-health: In one of the intervention arms, tele-health support will be provided by a doctor for common health problems, at participant's own discretion. each call may last up to 15 minutes. This support will be provided for general health problems only where a doctor can provide support without physically examining pregnant women. Arm 1: IVR + Tele-health – Participants will be able to interact with the messages system using the keypad of their phone and will be able to contact a project doctor to discuss their health and the heath of their babies once they are born. Arm 2: IVR - Participants will be able to interact with the messages system using the keypad of their phone Arm 3: Control – N intervention will be given. Text: Participants will receive one push notification once every two weeks, to encourage them to access information. Call: Participants will receive push call once every two weeks (following the text message stated above) to encourage them to access information. Dose: Participants are expected to listen to each IVR module at least once to measure the effect. The duration of each module is about 15 minutes. Participants can listen to the modules as many time they want. Procedure: Dissemination of maternal and child health information using mobile phone network and IVR. Who provided: Demonstration session will be observed by the project staff members who hold a bachelor's degree and have at least five years of experience working in maternal and child health and early childhood development. There will be a doctor to respond to the participants call or answer to their query over the phone in one of the intervention arms. How: Demonstration sessions will be conducted face-to-face. The modules will be recorded in voice-over form and stored using IVR technology. Participants will be able to access this information any time they want. Participants will receive push notification to encourage them to access information. Where: 330 villages in the southwestern part of Bangladesh. Arm 1: 110 Arm 2: 110 Arm 3: 110 When and how much: Demonstration session: At the end of baseline 1 session Modules: 15 modules stored and accessible using IVR Text: 1 push notifications every two weeks (1 text followed by 1 call, for Arms 1 and 2) Dose: Participants are expected to listen to each IVR module at least once (1 time) to measure the effect. Help from doctors: Help from doctor will be available at specific time slots during the day in one of the treatment arms. Tailoring: The push notification will be tailored based on whether the participants are in antenatal or postpartum stages and the child’s age (in months). Modification: N/A How well: Planned: Each time an IVR module will be accessed and listened to, the number will be automatically recorded. Text messages will be sent by a team of project staff members who will be supervised by a team leader. A senior project staff member will ensure whether IVR modules are accessible by keeping an update, using a log, of accessible modules. Doctor: Doctor will be given a separate mobile phone with a dedicated number, with field-level monitoring in place. Actual: If IVR was available to Arm 1 and 2, doctor was accessible via phone, push text and call were made