Can a missed call from the mobile phone improve maternity care in Rural India?

This is a guest blog by Rajamanohar, Co-Founder and Managing Director of Hexolabs Interactive Technologies Pvt. Ltd. Rajamanohar heads an interdisciplinary research team that develops grounded solutions around mobile telephony services to reach out to the rural masses in India. He has been conferred the ‘TED India Fellowship 2009’ and also the ‘National Internet Exchange of India (NIXI) Fellowship’.

Mobile Telecommunication has truly transformed and overhauled India’s traditional institutions of communication and transaction. How else can one explain the almost complete lack of dependence on the once mighty Postal Department by most Indians today for the purpose of communication? The inherent desire of people across this vast country, especially the majority of those living in rural India to communicate better with their institutions and social circles has enabled the mobile technology to penetrate deep into rural India, seemingly breaking the barrier of poverty to reach out to the needy and downtrodden as a harbinger of hope and development. Mobile devices have not only catered to the personal communication needs of Rural India but have also started to provide solutions for systemic and societal welfare issues that greatly empower rural India.

An interesting transformation I believe taking place across Rural India is the Jugaad usage of voice based mobile services. Particularly in domains of Rural Health, Maternity Care and Family Planning, voice based services have been effective in reaching out to the masses, trying to bring about a positive change in their lives. But why do I believe that basic voice call has the potential to penetrate and engage its rural users in ways never before imagined? Simply because of India’s population and demographics.

Take the example of Lakshmi, a healthcare worker from Rural India. Research conducted by our team in the Pollachi District of the southern state of Tamil Nadu reveals that the professional challenges of a health worker catering to the medical needs of the hill dwellers are much more challenging than one could imagine. Lakshmi treks through 6 miles of forest that are hotspots for human encounters with wild elephant herds to provide the most basic healthcare to that community. As one can imagine, it would be next to impossible for Lakshmi to spend enough time to take regular crash courses to improve their skill set. This is where the humble mobile finds its way into their ecosystem to enable Lakshmi and countless other healthcare workers like her to get the vital information that enriches their Knowledge bank while saving them of precious time. Training in person is no doubt the ideal methodology but in scenarios such as Lakshmi’s when that is rendered impractical, tapping into the ubiquitous Mobile phone and its possibilities is a blessing indeed.

Interestingly, our study suggests that culture sensitive and flexible features like the ‘Missed Call’ evoke far more positive response from users of voice based services. The ‘Missed Call’ is a unique innovation in mobile device usage across India wherein a user only needs a minimum balance in their prepaid SIM card to use their device to give a missed call to another number such that the user at the other end calls them back to converse. The missed Call feature has proved extremely successful especially in the low credit scenario where a service is provided on demand rather than being pushed at pre ordained intervals during the day. The push based voice services are annoying to its users, interrupting their daily life especially in the case of health workers who travel miles to provide services to the unreached masses. There are many patients even with severe ailments who wait for the arrival of the health worker to follow their advice thus making it pertinent to not intrude upon the trusted health worker’s routine. Another reason why features like the ‘Missed Call’ prove effective is because of Cultural sensitivity to local demographics.

Our own analytics suggest that a toll free setup for healthcare workers sees a 30% uptake but when the same service was offered via Missed Call the uptake increased to 70%. This sudden surge truly puzzled us until a little research revealed that culturally in India, the humble ‘missed call’ is perceived as a trustworthy tool in case of emergencies or lack of funds for recharge, particularly amongst the rural women population as compared to a Toll Free number which, however free is not perceived to be free!

While the future holds exciting prospects for mobile phone based healthcare service delivery, it is also very important to understand and analyze the limitations of mobile phones. Experience shows that Voice alone as a medium of communication isn’t necessarily foolproof and requires in depth research to understand if it could help address issues without alienating or exasperating the users. Research and implementation go hand in hand at every phase to ensure that the solutions are tailored to the masses. In that sense, voice based services are quick to test on ground with real users and our method of continuous feedback and iteration helps us make the system and its services a continuously evolving and improving social solution- All the more reason why our team at Hexolabs is passionate about the use of one’s Voice in the future where many other technical interventions have failed in the past towards Rural empowerment.

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