Improving health outcomes through texting
Jorge Luis Díaz González is Director of Open Participation and Communities at the National Digital Strategy, Office of the President of Mexico. He will be speaking at LabWorks 2015, our global lab gathering on 8 July. Find out more.
Imagine this: you are a pregnant woman in rural Mexico, your income is below the established poverty line around two dollars per day, 60% of your income comes from social benefits and welfare programmes, and you travel up to 16 kilometers monthly for your routine check-up.
This story is true for nearly 1 in every 5 pregnant women in Mexico.
According to the Millennium Development Goals, maternal mortality should have been reduced by three fourths by this year. Currently, the rate stands at 39 deaths per 100 thousand newborns and we are still far from reaching the goal of 22. There has been great progress, and to continue our efforts, the Office of the President of Mexico is working on a new approach. We see that the lives of pregnant women can be positively changed by harnessing mobile technologies, thereby creating a deep impact in their development outcomes.
As part of this new approach, the Mexican Government is working on a project within the current framework of Prospera, Mexico’s largest social development initiative and the second largest conditional cash transfer programme in the world.
The idea behind Prospera is simple: provide monetary support to encourage impoverished Mexican mothers to send their children to school and attend preventive health-care clinics. Co-responsibility on family compliance to improve nutritional, health, and educational outcomes proved revolutionary back in the 90’s. Conditioning cash transfers to those whose per capita income was below the minimum poverty line became a model then replicated by more than 50 countries in Latin America, Asia, and Africa.
Now, a pilot for Prospera Digital is going to launch. This will be based on other successful mobile technology development experiences like Liberia’s mHero, Zambia’s U-Report, and Afghanistan’s EduTrac.
In the upcoming months, Prospera Digital will direct automated SMS communication to pregnant beneficiaries in order to bring them timely, personalized, and targeted information that will help them make better-informed decisions and improve their health-related behaviour. RapidPro, developed by UNICEF, will allow the creation of customised texts, interactions and strategic information delivery based on a system of modular components tailored to individual profiles. Each message will be sent considering each user’s specific needs.
To ensure success, the National Digital Strategy gathered a team formed by UNICEF, the Behavioural Insights Team, MIT Media Lab, Data Science for Social Good at the University of Chicago, RapidPro, and Qué Funciona para el Desarrollo, as well as one of the largest mobile carriers in the world, Telefónica-Movistar. The project is supported by the FCO's Prosperity Fund.
The pilot phase will measure the effect of the messages’ content on health outcomes, and how women interact and respond to the technology. The initial results will help explore the possibility of escalating the pilot to the national level. We calculate that up to 10,000 Prospera beneficiaries in more than 600 communities will be part of the pilot phase, and will be spread across four groups with different levels of SMS-interaction and content.
We are hoping that the Mexican story of maternal mortality will change. Information has been at the center of the issue, and we are currently developing the message flows that will incentivize better-informed decisions, helping them detect early symptoms associated to potentially critical complications. The anonymized feedback from the SMS data will be used in real time to analyze and improve the communications model, generating evidence on what type of messages triggers better responses.
The Prospera Digital pilot will improve women's lives by delivering timely information that incentives better health choices during the different stages of their pregnancies, whilst detecting potentially life-threatening conditions. In addition to improving lives, mobile technology will be used to make the Mexican Government’s response to its citizens more efficient and focalized.
The pre-pilot phase of this project is to be launched no later than July 15th, 2015. Jorge will discuss further at the LabWorks 2015 conference on 8 July.