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Currently submitted to: Journal of Medical Internet Research

Date Submitted: Aug 25, 2017
Open Peer Review Period: Aug 27, 2017 - Oct 22, 2017

NOTE: This is an unreviewed Preprint

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My Doctor Sister, My Nutrition Sister: Feasibility, acceptability and compliance with an integrated package of nutrition counselling and unconditional cash transfers on a mobile platform to improve maternal and child nutrition

  • Tanvir M Huda; 
  • Ashraful Alam; 
  • Tazeen Tahsina; 
  • Mohammad Mehedi Hasan; 
  • Jasmin Khan; 
  • Mohammad Masudur Rahman; 
  • Abu Bakkar Siddique; 
  • Shams El Arifeen; 
  • Michael J Dibley

ABSTRACT

Background:

Inappropriate feeding practices, inadequate nutrition knowledge and insufficient access to food are major risk factors for maternal and child under nutrition. There is evidence to suggest that the combination of cash transfer and nutrition education improves child growth. However, it will require cost effective delivery platform to achieve the complete coverage of these interventions in the population

Objective:

This study aims to assess feasibility, acceptability and the compliance of an intervention package of voice messaging, direct counselling, and un-conditional cash transfers all on a mobile platform for changing perceptions on nutrition during pregnancy and the first year of the child’s life.

Methods:

We conducted a mixed method pilot study. We recruited 340 women. The women were either pregnant or lactating. The intervention consisted of an unconditional cash transfer combined with nutrition counselling both delivered on a mobile platform. The participants received BDT 787 per month and were given a mobile phone. The nutrition message and counselling were delivered by voice message and conversations with a counsellor from a call centre. We carried out cross sectional surveys at base line and end line, focus group discussion and in-depth interviews with participants and their family members.

Results:

The poor rural women were interested both in voice messages and direct counselling. Most women reported that they had no problem in operating the mobile phones and listen to the voice messages. There were also able to interact freely with the counsellor. Charging of the mobile handsets posed some challenges. Less than 50% households had electricity at home. However almost all families, which did not have electricity at home were able to find a solution. They either charged their mobiles at their neighbour’s house or at a market place. No major barriers were identified with the use of mobile banking for cash transfers. Regarding the use of cash, our study reported that one of the highest priorities for poor families was purchasing food.

Conclusions:

The use of mobile platform for cash transfer and nutrition counselling is a feasible and acceptable strategy and has the potential to be used in large-scale programs to improve maternal and child nutrition.