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Currently accepted at: JMIR mHealth and uHealth

Date Submitted: Aug 25, 2017
Date Accepted: May 13, 2018
(closed for review but you can still tweet)

This paper has been accepted and is currently in production.

It will appear shortly on 10.2196/mhealth.8832

The final accepted version (not copyedited yet) is in this tab.

The final, peer-reviewed published version of this preprint can be found here:

Mobile-Based Nutrition Counseling and Unconditional Cash Transfers for Improving Maternal and Child Nutrition in Bangladesh: Pilot Study

Huda TM, Alam A, Tahsina T, Hasan MM, Khan J, Rahman MM, Siddique AB, Arifeen SE, Dibley MJ

Mobile-Based Nutrition Counseling and Unconditional Cash Transfers for Improving Maternal and Child Nutrition in Bangladesh: Pilot Study

JMIR Mhealth Uhealth 2018;6(7):e156

DOI: 10.2196/mhealth.8832

PMID: 30021707

PMCID: 6070725

Mobile-Based Nutrition Counseling and Unconditional Cash Transfers for Improving Maternal and Child Nutrition in Bangladesh: Pilot Study

  • 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 undernutrition. There is evidence to suggest that the combination of cash transfer and nutrition education improves child growth. However, a cost-effective delivery platform is needed to achieve complete, population-wide coverage of these interventions.

Objective:

This study aimed to assess the feasibility, acceptability, and perceived appropriateness of an intervention package consisting of voice messaging, direct counseling, and unconditional cash transfers all on a mobile platform for changing perceptions on nutrition during pregnancy and the first year of a child’s life in a poor rural community in Bangladesh.

Methods:

We conducted a mixed-methods pilot study. We recruited 340 pregnant or recently delivered, lactating women from rural Bangladesh. The intervention consisted of an unconditional cash transfer combined with nutrition counseling, both delivered on a mobile platform. The participants received a mobile phone and BDT 787 per month (US $10). We used a voice messaging service to deliver nutrition-related messages. We provided additional nutrition counseling through a nutrition counselor from a call center. We carried out cross-sectional surveys at baseline and at the end of the study, focus group discussions, and in-depth interviews with participants and their family members.

Results:

Approximately 89% (245/275) of participants reported that they were able to operate the mobile phones without much trouble. Charging of the mobile handsets posed some challenges since only approximately 45% (124/275) households in our study had electricity at home. Approximately 26% (72/275) women reported they had charged their mobile phones at their neighbor’s house, while 34% (94/275) reported that they charged it at a marketplace. Less than 10% (22/275) of women reported difficulties understanding the voice messages or direct counseling through mobile phones, while only 3% (8/275) of women reported they had some problems withdrawing cash from the mobile bank agent. Approximately 87% (236/275) women reported spending the cash to purchase food for themselves and their children.

Conclusions:

The nature of our study precludes any conclusion about the effectiveness of the intervention package. However, the high coverage of our intervention and the positive feedback from the mothers were encouraging and support the feasibility, acceptability, and appropriateness of this program. Further research is needed to determine the efficacy and cost-effectiveness of mobile-based nutrition counseling and unconditional cash transfers in improving maternal and child nutrition in Bangladesh.


 Citation

Please cite as:

Huda TM, Alam A, Tahsina T, Hasan MM, Khan J, Rahman MM, Siddique AB, Arifeen SE, Dibley MJ

Mobile-Based Nutrition Counseling and Unconditional Cash Transfers for Improving Maternal and Child Nutrition in Bangladesh: Pilot Study

JMIR mHealth and uHealth. (forthcoming/in press)

DOI: 10.2196/mhealth.8832

URL: https://preprints.jmir.org/preprint/8832

PMID: 30021707

PMCID: 6070725

Per the author's request the PDF is not available.