Community Health Worker Mobile Support Tool
MSl and Viamo aim to equip Female Community Health Volunteers with the skills and knowledge to provide SRH services during emergencies.
An MSI Community Health Worker provides family planning training in her community.
What specific problem(s) are you trying to address?
The needs of reproductive age women are oftentimes overlooked during emergencies but they are among the most vulnerable and at risk populations. FCHVs are the first respondents during emergencies but they are not always equipped with the knowledge and resources to respond to the unique situation and they have various levels of knowledge and skills, the terrain and remoteness makes it difficult for them to attend training. This is compounded when landslides, flooding, etc wipe out road networks and existing infrastructure. At the same time organizations don't know the ground situation making it difficult for them to deploy needed resources in a timely manner leading to high maternal and newborn morbidity and mortality which can be prevented.
This year Nepal faced unprecedented rains leaving the whole southern agricultural belt, the Terai, underwater. An estimated 1.7 million people were affected by the floods.
Nepal is prone to landslides, especially during monsoon season. The landslides wipe out road networks, destroy homes & livelihoods, and leave whole communities displaced to start over.
Geologically, Nepal is considered to lie on a seismic zone which experiences frequent earthquakes. As a result, earthquakes of various magnitudes occur almost every year and have caused heavy losses of lives on several occasions including the recent 2015 earthquake, affecting an estimated 8 million people.
What are some of your unanswered questions about the problem(s) you are working to address?
MSI would like to work with other emergency response parties to design and implement a seamless mechanism to quickly and effectively respond to emergency situations. Currently emergency responses are disaggregated and require bureaucratic process to be approved, slowing the response time during emergencies. How can the parties work together ahead of time to develop a first response mechanism? How can we prepare community health workers to be ready for the next natural disaster?
Explain Your Idea
Viamo has an on-demand information service called “321”; people can access the service using their own mobile phones, however basic, at no cost. At a moment of need, callers use their own phones to dial the toll-free number 321 anytime, anywhere and retrieve the information they need.
In a series of "listen, then choose" steps, callers use their telephone keypad to select from among hundreds of pre-recorded voice messages. Viamo, in partnership with MSI, propose adding a Female Community Health Volunteer Job Aid section as a secret topic, not listed to the general public, on 321 in order to raise awareness and training around SRH for FCHVs with an emphasis on responding in times of natural disasters and armed conflict. The goal is to deliver messages that inform on SRH issues; support services available to FCHVs; address harmful gender norms and discrimination; and more.
To develop messages that are accurate, relevant, and aligned with national priorities and guidelines Viamo will form a “content committee,” comprised of our key stakeholder, MSI, along with other national and international experts. The mobile job aid will be complemented with push messages during emergencies. Interactive Voice Response surveys will be deployed to learn the extent of the damage, the immediate needs of the community, and the knowledge and supply needs of the FCHVs. The data can be used in real-time to inform humanitarian efforts, deploying resources where they’re most needed.
User Experience Map 4
User Experience Map 3
User Experience Map 2
User Experience Map 1
Name the three most important ways that your idea will address your identified problem(s).
There three main goals are: (1) increase the capacity of FCHVs; (2) ensure FCHVs have the supplies and knowledge to serve their communities during emergencies; and (3) provide emergency response parties with real-time data for decision making.
The Mobile Job Aid will give FCHVs a reliable tool to access expert created SRH information. They can systematically go through the information, taking short quizzes after completing content sections, or reference the Mobile Job Aid in a moment of need. The on-demand content will be complemented with push messaging immediately following an emergency. The data collected will be used to update the Mobile Job Aid and inform humanitarian aid to effectively respond.
How is your idea unique?
Developing the capacity of FCHVs has traditionally been done through in person trainings, this is hindered by Nepal’s topography. When trainings are held they require large amounts of information to be covered in a short amount of time, causing learning fatigue and low retention rates. An IVR job aid compliments traditional trainings by giving FCHVs a tool to refresh their memory on key skills and information.
Furthermore, the 321 service represents a paradigm shift in information services. Instead of the development world pushing information, they have on-demand access to the information, accessing the service in their moment of need and applying the information to their work without requiring a new phone or tablet. Lastly, unlike a new toll free number created for a particular emergency, 321 is always available to users and covers a range of topics. Users create a habit of calling into the service to find information on various topics and know to use it before an emergency.
What are some outstanding concerns or questions that you have regarding your idea?
Will the mobile job aid be welcomed by the Female Community Health Volunteers? Will they use it on a regular basis?
How can we engage FCHVs in the process?
What is the best way to present the information? In Q&A form, podcast style, or as lecture series?
Do all FCHVs have network connectivity in their communities? Will the mobile networks continue to work during natural disasters?
What are the information needs of FCHVs, especially during times of natural disasters.
Who are your end users?
The direct user of our service are the FCHVs. They will benefit by having on-demand access to reliable, expert created SRH information. In addition, they will be able to request resources and information during times of natural disasters to help them respond to the emergency context and continue to help their communities. MSI workers with a network of 20,000 female FCHVs ranging from urban slums to the most rural and hard-to-reach communities.
Indirectly, community members will benefit from the knowledge and services provided by the FCHVs. We expect 180,000 to 270,000 community members, predominantly girls and women ranging in ages from 10 to 40 years old, will benefit from the increased capacity of FCHVs.
An MSI Community Health Worker aids a displaced women.
Where will your idea be implemented?
What is the primary type of emergency setting where your innovation would operate?
Community at risk of disaster
Tell us more about the emergency setting that you intend to implement in
Nepal is prone to natural disasters and armed conflict. Some of the most common natural disasters are landslides, flooding from heavy rains, earthquakes, and forest fires. Floods and landslides are the most common, occurring every year during monsoon season. They claim many lives and cause major damage such as destruction and blockages of highways, loss of dwellings, and destruction of livelihoods. Nepal is also susceptible to conflict, especially in the Terai, causing the region to be paralyzed
What is your organization's name?
Marie Stopes International (MSI)
Tell us more about you.
MSI and Viamo are partnering to run this intervention. MSI, as the domain expert, will be responsible for the design of the content. Viamo, as the technology and channel expert, proposes to play the role of modernizing the access to content to the target populations.
MSI Nepal and its partner, SPN, have been delivering family planning and safe abortion services to thousands of women across the country since 1994. Using an advocacy-based approach, our teams are increasing awareness and understanding of contraception, particularly targeting the underserved.
Viamo is a social enterprise dedicated to bringing the benefits of technology to individuals and organizations working in the developing world. We amplify the voices of the unhear
What is the current scale of your proposed innovation?
Still in planning phase and does not exist yet
Experience in Implementation Country(ies)
Yes, for more than one year.
Expertise in Sector
Yes, for more than a year.
MSI Nepal and Viamo are both registered and based in Kathmandu, Nepal. MSI is registered as an INGO and Viamo is registered as a PVT LTD.
What is your organizational status?
Registered non-profit, charity, NGO, or community-based organization.
What is the maturity of your innovation?
Early Stage Innovation: exploring my innovation, refining, researching, and gathering inspiration.
How has your idea changed based on feedback?
During the feedback stage we held two focus groups, acquiring input from 42 FCHVs. The purpose of the focus group was to get insight and feedback from the FCHVs on their phone usage, a FCHV job aid prototype, how to phrase content, etc. Overall, the response was positive, key insights included:
The FCHVs felt the job aid would help them gain knowledge and credibility in their communities. They felt the prototype was easy to use, they only had to call and use their keypad to reach the information; 40 FCHVs preferred making calls over SMS (the Nepali script is difficult to write on phones).
They preferred messages that were a casual dialogue and that mentioned the Ministry of Health for credibility; they also suggested using a female voice.
They highlighted the importance of post disaster information to reduce anxiety and continue work.
19 FCHVs were avid facebook users, adoption of smartphones is increasing, to stay relevant FB chatbots can be added as an additional channel.
During the feedback stage we hosted 2 focus groups, acquiring insight from 42 FCHVs. The objective of the focus groups was to better understand the challenges FCHVs face and their mobile phone preferences as well as gather feedback on the job aid prototype. In this picture an FCHV small group is working on what they liked most about the prototype, what they liked the least, and how they would change it. They later presented their thoughts to the group.
Who will implement this idea?
MSI and Viamo are partnering to run this intervention. MSI, as the domain expert, will be responsible for the design of the content and promoting the service to the FCHVs. MSI will have two full-time staff members working on the project, primarily developing the content. In addition, the 36 Demand Generating Coordinators, one per District, will organize introductions to the FCHVs. Viamo, as the technology and channel expert, proposes to play the role of modernizing the access to content to the target populations. Viamo will have two full-time staff working on the project. The Nepal Country Manager will continue to work closely with MSI to design the mobile application and content. Viamo's Project Success Team will implement the project and analyze usage statistics to make needed iterations
Using a human-centered design approach, you may uncover insights that lead to small or foundational changes to your organization’s existing strategy or processes in order to unlock the potential of your idea. How would your organization go about making such changes?
Since MSI is a donor-funded programme, we run various projects in line with project agreements with donors. When an insight emerges that will benefit our overall organization and the implementation of such an insight into overall programming does not require significant financial or human resources investment, the Senior Management Team discusses the change, implementing it where applicable; the Country Director makes the final decision. Some decisions that may have a significant impact on operations are elevated to the Global office in London. To get buy-in we need to show the Senior Management Team evidence on the benefit of the change, the implementation plan, and demonstrate the impact to the overall programme.
What challenges do your end-users face? (1) What is the biggest challenge that your end-users face on a day-to-day, individual level? (2) What is the biggest systems-level challenge that affects your end-users?
FCHVs reported the biggest challenge they face is access to timely information. FCHVs are approached by community members to answer a plethora of health questions. If the FCHV is unable to answer the question or point the individual to a resource they lose credibility. During natural disasters/conflict the FCHVs are under even more pressure to know what is happening, which clinics are open, etc.
The biggest systematic level challenge FCHVs face is access to supplies. During the earthquake supplies were sent to the communities but FCHVs didn't know what supplies were available and where they were located. The people that received the supplies also didn't know who should be using them or what they were used for. As a result a lot of the medication expired and pregnancy kits were unused.
During the feedback stage we held 2 focus groups with 42 FCHVs. FCHVs talked about the challenges they face, the main challenge was access to information. They highlighted the importance of information during natural disasters when everyone is anxious and unsure of what to do. Information at that time would allow them to reassure themselves and their communities and allow them to continue doing their work.
Tell us about your vision for this project: (1) share one sentence about the impact you would like to see from this project in five years and (2) what is the biggest question you need to answer to get there?
Impact: By 2022, we aim to reach 20,000 FCHVs with our mobile job aid, impacting 2,000,000 women and girls at the community level through these FCHVs.
Question: How do we iterate the mobile application to retain FCHVs usage; adapt to changing information needs and smartphone penetration; and measure impact at the community level to achieve our vision for 2022: of aiding 20,000 FCHVs, impacting 2,000,000 girls and women with improved sexual and reproductive health services?
What is it that most attracted you to Amplify instead of a more traditional funding model?
We were attracted to Amplify because of the human-centered design and collaborative international development model. We look forward to Amplify expertise to help us design and build an effective, user-centric mobile job aid for FCHVs; the flexibility in funding will give us the opportunity to iterate the design as we continue to get feedback from the users compared to traditional funding. We also believe development should be collaborative, especially during disasters.
Do you intend to implement your Amplify idea in refugee camps / temporary settlements?
We aim to implement our Amplify idea in support of displaced populations, but not in a refugee camp / temporary settlement.
How long have you and your colleagues been working on this idea together?
How many of your organizations’s paid, full-time staff are currently based in the location where the beneficiaries of your proposed idea live?
Over 50 paid, full-time staff
Is your organization registered in the country you intend to implement your idea in?
We are registered in all countries where we plan to implement.
My organization's operational budget for 2016 was:
What do you need the most support with for your innovation?