Impact Examples: ICT4D Programming

Bangladesh Knowledge Management Initiative: Effects of a Digital Health Training Package on Client Family Planning Behaviors

A cross-sectional study was designed by K4Health to test the effects of a digital health training package on family planning behaviours in Bangladesh. There were 3 exposure group categories: mothers who reported no home visit from a fieldworker (no exposure); mothers who reported receiving a home visit from a fieldworker who had a netbook with the digital health training package (low exposure); and mothers who reported receiving a home visit from a fieldworker who had a netbook with the digital health training package and were shown a digital resource during the visit (high exposure).

A 2017 evaluation showed:

• With regard to fieldworkers' behaviours: Using logistic regression modeling, K4Health found that both low and high levels of exposure to the digital health training package were associated with higher odds of mothers reporting that the fieldworker discussed various contraceptive method options, side effects of methods, and what action to take with regard to side effects. For example, mothers in the high-exposure group were 2.73, 3.29, and 3.23 times more likely to report that the fieldworker discussed contraceptive choice, discussed side effects, and provided information regarding actions the mother could take if she experienced side effects related to contraceptive use, respectively, compared with mothers in the no-exposure group.
• With regard to mothers' current contraceptive use: A high level of exposure was associated with higher odds of mothers reporting current contraceptive use. For example, mothers in the high-exposure group were 1.85 times more likely to currently use contraceptives compared with mothers in the no-exposure group.

Gyan Jyoti - Generating FP Demand via Mobile Phones

Created as part of Project Ujjwal (2013-2015), Gyan Jyoti ("light of knowledge") is an open source android-based phone app whose purpose is to generate family planning (FP) demand in the states of Bihar and Odisha in India. Gyan Jyoti was designed specifically for use by community health workers (CHWs), who visit homes in rural areas to promote FP and other healthy behaviours. The app contains a variety of persuasive audiovisual (AV) materials about FP behaviours and modern contraceptive methods. In one district of Bihar, smartphones loaded with the Gyan Jyoti app were given to 14 ASHAs, while in another comparable district, another 14 ASHAs were supplied with low-tech SD cards containing the same AV content.

A May 2015 random sample of 406 women from 2 districts with similar characteristics found:

• Clients who watched videos were 4.5 times more likely to use modern contraceptive methods than those who did not.
• 22% of women who were counseled with the app were using modern contraception such as IUDs, oral contraceptive pills, and injectable contraception at the end of the study period, whereas 13% of the women were using modern contraception in the district without the app.
• Women who were visited by an ASHA during the study period were 1.9 times more likely to be using modern contraceptive methods.
• Of the 75 women in the intervention district who were using modern contraceptive methods at the end of the study period, three-quarters of them had interacted with the app.
• Visits by Accredited Social Health Activist (ASHA) workers were up 56% in the intervention district, compared to 47% in the SD card district.

Half the Sky Movement Multimedia Communication Initiative: An Evaluation of the 9 Minutes Mobile Game and Video

Half the Sky Movement is a global multi-media, multi-partner initiative using handheld mobile games as a tool to promote healthy behaviours in India and East Africa on topics such as maternal health, child health, and girls' education and empowerment. One of these games simulates the experience of 9 months of pregnancy in 9 minutes, presenting players with a series of physical, medical, and social choices in a race against the clock.

Key findings (2012):

Significant increases in knowledge-related items were found - most notably around correct knowledge of the number of optimal antenatal care (ANC) visits and key pregnancy "dos" and "don'ts". The findings also revealed significant shifts in key outcomes correlated with behaviour change: increased perceptions of susceptibility to and severity of pregnancy/delivery complications in the absence of appropriate ANC or institutional delivery; increased perceptions of benefits; decreased perceptions of barriers; increased perceptions of supportive community norms around pregnancy/delivery and gender; increased self-efficacy; and increased intentions to act related to the 9-Minutes topics.

Battlestorm Social Impact Game: Summary Evaluation Results

Battlestorm is a game that engages youth in efforts to keep communities on the Gulf Coast of the United States (US) safe in case of natural disasters, such as Hurricane Katrina. It combines elements of theatrical spectacle, reality game show, physical sport, and an online community (website or Facebook page).

Conducted from March 10 to May 21 2011, the evaluation showed:

• Between the baseline and follow up, a greater share of Battlestorm players started or continued talking with their parents about how to be prepared for a hurricane (68%) than youth in the control group (38%). Players were also more inclined to talk to friends about hurricane-related subjects.
• One-third of parents reported that they learned something new from their child who played the game, and 25% reported that they learned something new from watching the Battlestorm game. At the baseline, parents of Battlestorm players had, on average, 13.4 of 22 important items to have in case of a hurricane emergency. At the follow up, parents had, on average, 16.5 important items.

Text Me! Flash Me! Helpline - Ghana

This project uses cell phone technology to provide most-at-risk populations (MARP) with friendly and accessible HIV and AIDS information, referrals, and counseling services from qualified providers. The Helpline was launched in September 2008 through a pilot focusing on men who have sex with men (MSM) exclusively, and then was expanded in February 2009 to include female sex workers (FSW).

Text Me! relies on a database of cell phone numbers collected by peer educators and social networks. Outgoing SMS texts are sent with educational and promotional messages, either through a "phased communication" strategy or in response to trends noticed through ongoing quality assurance and monitoring and evaluation (M&E). Automatic SMS text responses are sent to clients' SMS text inquiries that refer clients who text "HELP" to live Helpline counselors, who call back within 24 hours.

The Flash Me! component of the project refers to the fact that, in order to encourage clients to call and use a Helpline, it is important that the call is free to the client. However, in Ghana, there is currently no way to procure a phone number that will be free for all callers from all networks. The solution was that potential clients may "flash" the cell phone number of a Helpline counselor on duty, who returns the client's call within 24 hours. Helpline counselors' cell phone numbers and duty hours are disseminated both through social networks, discrete fliers, and by peer educators.

2009 evaluation showed:

• The number of callers disclosing their sexual orientation to a Helpline counselor increased each month. In addition:
  - 86.9% of survey respondents said that after their Helpline call session they shared the information they received with others;
  - 40% of respondents forwarded the texts they received to others, and sent to an average of 8.6 other people;
  - Respondents who forwarded texts said their reason for doing so was either to educate others, or because they wanted them to have the same information;
  - Only 13.1% of clients said they did not share the information with anyone.
• The evaluation findings revealed that the Helpline increased clients' knowledge of and intention to use condoms and lubricants.
• Of the survey respondents who were referred for services by a Helpline counselor; 47% reported that they followed up and went for these services; 77% said they intended to go for counseling and testing (CT) services; 23% said they did not intend to, mainly because they said were "already aware of my HIV status" or had "already taken the HIV test". The sum total of CT service uptake in Oct. 2008 was higher than the uptake numbers in the previous 5 months combined at the MSM drop-in center at one of the project's local NGO implementing partners: 69 clients from May to Sep. 2008, as compared to 76 clients in Oct. 2008.
• CT uptake following referrals increased after the launch of the Helpline:
  - 16% effective referrals over the period of Apr.-Aug. 2008;
  - 39% effective referrals over the period of Sep. 2008-Jan. 2009.
  - Prior to the Helpline, only 1% of MSM referred to the MSM drop-in centre at one of the project's local NGO implementing partners for sexually transmitted infection (STI) services actually went and received STI services. Following the launch of the Helpline Pilot, that number increased to 11%.
  

School-Based Information And Communication Technology Centre in Binga District, Zimbabwe

This school-based ICT centre was equipped with computers and supported by a training component that trained school personnel, students, and community members in the use of the computers, accessing information online, and communicating with others via email.

2004 evaluation showed:

• The establishment of Binga High School ICTC has been widely accepted by staff at the school and the general public. The computers and the internet have afforded the people the opportunity to access information to which they would not otherwise be able to access. For instance, the dearth in cost of books and study materials has been alleviated by accessing the requisite information on the internet. In addition, the public can also access newspapers on the internet as these are not delivered to Binga because of its remote location. The availability of e-mail services has also facilitated a cost-effective means of communication.
• The people that have been trained in the use of computers comprise the school pupils, teachers, local government officers, and the general public.
• The Binga ICTC is now hosted in three schools.

AIDSWEB Project - Botswana, Ghana, Kenya, South Africa, Uganda, United States, Zambia, Zimbabwe

Launched in 1998, this AIDSWEB project aimed to offer secondary-school students training and access to technology, accurate information about HIV/AIDS, and guidance in initiating and sustaining action to combat the disease through national and cross-national partnerships.

2002 evaluation showed:

• AIDSWEB students were almost twice as likely to correctly identify all 4 methods of AIDS prevention and transmission. These results were consistent across countries, except for Uganda (a country that, according to evaluators, has well-established programmes in HIV/AIDS education and youth development).
• 63% in the control group and 85% of the intervention group responded that they helped their communities by sharing information about HIV/AIDS with family, friends, and/or health workers about HIV/AIDS; volunteering with local organisations or health clinics/hospitals; or developing a social action plan. AIDSWEB students were similar to students outside the programme in their choices of social action, but AIDSWEB students were more than twice as likely to develop social action plans.

Radio Sagarmatha - Nepal

Radio Sagarmatha is an independent community broadcasting station run by environmental journalists in Nepal. In addition to environmental issues, information and communication technology (ICT) is a central focus.

"Sagarmatha Site" is a 15-minute recorded programme in three segments that include: discussion and live browsing of a featured website (with a focus on international websites); "Sabdartha," which explores technical language related to the internet; and the exploration of research techniques by an experienced internet user. Listeners are invited to call in with specific requests for information or computer-related assistance; studio personnel consult the internet to answers questions on the air. There are also live broadcasts of major ICT events taking place in Kathmandu.

In March, 2002 a radio quiz was initiated and is conducted fortnightly. Winners are rewarded with free training, which is sponsored by private corporations, in ICT.

2002 evaluation showed:

• The radio quiz has inspired a growth in the number of letters and e-mails by 200%. As the programme has progressed, broadcasters have received an increasing number of requests for specific information about ICT. They have also received more computer-related questions, such as inquiries about how to fix computer hardware and software problems.
• Due in part to the full automation of Sagarmatha's broadcast operation, the programme de-mystified the technology to producers and technicians at the station. When the programme started, there was a single computer, but now there are ten. Many programmes are directly recorded in computers in MP3 format and played on air. The daily archives of the broadcast are also kept on CD-ROMs in MP3 format. A CEO of an local ISP, ITNTI, provided free web hosting and e-mail service for the radio station after he came to the studio for the interview.