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Missed Call SOS - Getting help when you've got no credit

I got this idea from community health workers in Karachi, Pakistan. Build on existing habit of "missed" calls to communicate without spending credit. 1 missed call "I need some advice" -- 5 missed calls "urgent care required"

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The women I used to work with in Karachi never seemed to have any credit, but their phones were always ringing!

I discovered that they had a built-in code. I've forgotten the specifics - it was fairly elaborate (I could ask my friends in Karachi to find out if folks are really interested) - but I remember one missed call was just a "Hi! I'm here" and it escalated to five missed calls - something's up you need to call me back asap.

This is just a small idea, about supporting access to services already in place - getting those services there is a separate matter.

Families are communicated to about a service that doesn't cost them anything to access, but they can if they need urgent help, or juts have questions. They call a number and hang up once it connects:
* 1 time for "I need some advice"
* 3 times for "something's wrong"
* 5 times "urgent care required"

At the other end of the phone could be:
* Their community midwife with a dedicated phone that is never answered
* A centralized service that can alert the appropriate midwife
* A phone line that's staffed by people who can dispatch midwives, ambulances, or just phone back the same day with some useful advice.

(you could start simple and if successful build up)

Alternative A: You could also have this as just a pure SOS - 5 rings for urgent care

Alternative B: Instead of the number of times called you could do the number of rings, but I think number of times makes intentions very clear.

I'm guessing that missed calling is the bane of mobile operators lives - they have to connect the call but they never get any revenue. If it was a formal program, you'd probably need their buy in, the NGO may even have to pay them a small amount of money per-missed call. This may require a cost-benefit analysis to see whether it is really having the hoped for impact.

My experience with this was in Karachi in Pakistan. I'm really interested to see what other people's experiences in other locations are of the communicating without spending credit phenomenon to build on this idea.


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Excellent application of local systems/knowledge! When I worked in Southern Africa people would often "buzz" me so I could call them back - seems like a natural extension that capitalizes on local resources (or lack thereof).

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