Impact Evaluation of Super Abbu: A Speech Based MNCH Platform in Pakistan
- Conditions
- Maternal and Child Health
- Interventions
- Other: Super Abbu
- Registration Number
- NCT04008199
- Lead Sponsor
- University of California, Davis
- Brief Summary
The investigators have developed, piloted, and propose to expand and to experimentally evaluate a speech-based service that connects expectant fathers to doctors and to each other over a simple phone call. This service, dubbed Super Abbu (Super Dad in English), addresses the challenges faced by existing efforts in several new and important ways:
* The service targets fathers. Currently, the entire public health infrastructure in Punjab is geared towards providing information to women.
* It supplements LHWs by providing information between LHW visits.
* It does so in a manner appropriate for those who are illiterate and do not have smartphones.
* It does not require synchronous phone calls. Expectant fathers can leave questions to be answered. And they can access past questions and answers asked by themselves and other users.
* Through experience developing, publicizing, and driving adoption of speech-based services, the investigators believe they can overcome the slow adoption rate faced by the Punjab Health Line. Principal investigator Raza previously developed and launched Baang in Punjab, an entertainment speech-based social service, similar to Reddit, which accumulated 42,500 calls by 1,550 users within 71 days of its launch. These users listened to 393,448 speech posts.
- Detailed Description
Problem: Pakistan has the highest neonatal mortality rate in the world (44.2 per 1000 live births), accounting for 7% of the world's neonatal deaths, and among the worst maternal mortality rate in the region (178 per 100,000 live births). These indicators remain high despite the best efforts of the government and NGOs to leverage modern practices and technology to improve maternal, newborn, and child health (MNCH). To this end, the province of Punjab, Pakistan has hired 48,000 Lady Health Workers (LHWs), has introduced multiple information communication technology (ICT)-based health monitoring systems, and has launched the Punjab Health Line staffed by 150 doctors 24/7. LHW effectiveness has been limited, however, given the size of Punjab (100+ million people). LHWs are expected to visit nine homes per day and in 40 minutes cover a long syllabus and perform several tasks. Similarly, high deployment costs, low smartphone penetration, and low literacy rates in rural areas have limited the effectiveness of ICT-based interventions. The Punjab Health Line has been ineffective for more mundane reasons-its adoption has been very slow despite extensive publicity.
Research goals and expected outcomes: Super Abbu itself will generate useful information on frequently asked questions for public health professionals. In addition, the investigators seek to evaluate the effectiveness of Super Abbu at reducing maternal and infant mortality rates, and key drivers of these rates, in Punjab, Pakistan. In order to do so, the service must first be expanded to accommodate a new base of users. The investigators will then conduct a careful, large-scale randomized control trial of the service to understand its impacts on drivers of maternal and infant mortality rates, such as the number of antenatal visits, tetanus injections administered before birth, iron supplements consumed, and breastfeeding during neonatal days, and attitudes about vaccination, breastfeeding, and delivery.
Impact on research fields: Current speech-based health services in the developing world either depend on the functionality of a smartphone, involve synchronous contact with a healthcare provider, only target women, are costly, or are any combination of these. Super Abbu pushes the envelope. In addition, a careful evaluation of the service conducted by an interdisciplinary team would impact future research in public health, in computer science/language technologies, as well as in development economics.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 276
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Treatment Super Abbu Treatment group will receive an invitation to join Super Abbu in addition to identical surveys to those in the control group.
- Primary Outcome Measures
Name Time Method For how much time in total do you plan to breastfeed [NAME] for? From childbirth through study completion, an average of 3 months \[DAYS/WEEKS/MONTHS/YEARS\]
How many times did she receive antenatal care during this pregnancy? From childbirth through study completion, an average of 3 months Language taken from Pakistan DHS.
Where did you give birth to [NAME]? From childbirth through study completion, an average of 3 months Language taken from Pakistan DHS; possible choices: \[OWN HOME, OTHER HOME, GOVERNMENT HOSPITAL, GOVERNMENT CLINIC, OTHER GOVERNMENT, PRIVATE HOSPITAL, PRIVATE CLINIC, OTHER PRIVATE\]
When [NAME] was born, was [NAME] very large, larger than average, average, smaller than average, or very small? From childbirth through study completion, an average of 3 months Language taken from the Pakistan DHS.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Lahore University of Management Sciences
🇵🇰Lahore, Lahore/Punjab, Pakistan