Aponjon
Aponjon ("the dear one") is an mHealth service offering advice and support by mobile phone to new and expectant mothers in Bangladesh. It is the first national scale mHealth service to have been launched under the auspices of the MAMA (Mobile Alliance for Maternal Action) global partnership. The program is sponsored by MAMA Bangladesh, in partnership with Dnet (A Social Enterprise) in Bangladesh. MAMA is led by USAID and Johnson & Johnson, with support from BabyCenter, mHealth Alliance and the United Nations Foundation.
Outline of service
"Aponjon" (the brand name of this MAMA Bangladesh service) delivers health information to mothers from the beginning of their pregnancy until the child’s first birthday. During pregnancy, Aponjon sends messages to tell the mother-to-be about warning signs in the appropriate trimester. It also connects women wherever they live to local health services that can be many miles or hours away. Once the child is born, Aponjon reminds users about the best breast feeding practices, explains the benefits of family planning and how mothers can best care for their babies. During the 89 week period spanning the beginning of pregnancy until the end of child’s first year Aponjon sends text messages every two weeks. While there are text messages for mothers that can read, there is also option for voice message for mothers who cannot. There are also separate versions tailored to urban and rural mothers depending on their socioeconomic position and environment.
When subscribed to the service (via self-registration, a call centre or a community agent), pregnant women and/or mothers receive two messages every week, while other registered household members receive one. These messages are timed to the mother’s gestational age or the baby’s birthdate and provide advice specific to the pregnancy cycle or baby’s age. Messages are also tailored to the recipient and the three main groups (women, husbands and other family members, e.g. others or mothers-in-law) all receive different messages tailored to their role (during the pilot, 80% of registered household members were husbands). Dnet designed this unique service through needs assessment research and formative research, including designing of the messages reviewed by BabyCenter.
Aponjon "Customer Service Center" and "Counseling Line"
A customer service center is operational from morning till late night to assist customers for registration process and to respond to their queries. Heeding the popular demand from the registered clients, Aponjon started the ‘Aponjon Counseling Line’ service in June 2013. The Aponjon Counseling Line is a 24-hour service staffed by doctors specializing in Obstetrics and Pediatrics, who receive calls from the existing subscribers of Aponjon and respond to their queries. The counseling line is attached to the existing Aponjon Customer Service Center and connects through the same hunting number via an IVR option. Queries made to the counseling line range from general medical advice to referral to nearby medical centers and doctors. The service has been greatly applauded and appreciated by the clients and has made a huge impact on the credibility of the service. Services from the Aponjon Counseling Line include:
- Consultation and advice for home management of mild medical problems
- Dissemination of information on medical issues and their explanation
- Advice on safety of specific medicines and over the counter drugs for expecting mothers, new mothers and their children
- Referral to health care providers and health facilities according to location
- Health tips
- Prescription interpretation
- Investigation reports interpretation
Development
Aponjon started its operations at a national scale on 18 December 2012 after the conclusion of a successful pilot. The pilot service started in September 2011 and ran in 13 locations of four districts with 1403 subscribers.
The national launch event was held on 18 December 2012 in Dhaka. Those attending included MAMA Global Director, Kirsten Gagnaire; USAID Bangladesh Mission Director, Richard Greene; Minister for Health and Family Welfare, Dr. A.F.M. Ruhal Haque; State Minister Dr. M. Mujibar Rahman Fakir; Senior Secretary for Health & Family Welfare; and Government of Bangladesh and event chair, Mr. Mohammad Humayun Kabir, along with members of the global health community.
Aponjon is continuing to acquire new subscribers: on 29 May 2014 Aponjon had reached more than 500,000 subscribers in Bangladesh, taking the service closer to the targeted coverage of 2 million mothers by 2015. This has been made possible through training and deployment of local community agents from Aponjon’s outreach partners - BRAC, MaMoni Project, National Health Services Delivery Project (NSHDP), Social Marketing Company (SMC), Fair Price International (Info Lady) and Union Information Service Center (UISC) of the Government of Bangladesh.
Impact
Aponjon impact evaluation show that almost two-thirds (63%) of Aponjon primary clients who have completed the Aponjon service cycle from the time of registration up to the delivery of a child attended at least four antenatal care (ANC) visits. This represents a 37% increase over a 2011 national baseline of 26% attending four ANC visits. It is also important to note that 45% of the Aponjon subscribers went to a facility for delivery and 32% chose safe delivery at home. The survey results were also encouraging for subscribers in the 'new mother' category. 56% of new mothers did a postnatal care visit, 91% of new mothers fed colostrum after delivery, and 83% of new mothers practiced exclusive breast feeding. The immunization rate of BCG was 96%, and immunization rate of Pentavalet was 100%. The phone survey revealed that overall 93% of subscribers were satisfied with the service.
Awards
- In 2012 MAMA won the Fast Company Innovation By Design Award, defeating more than 1,700 nominated organizations including Nike, Boeing, Ford, and Leap Motion and other industry leaders.
- In 2013, Aponjon was among the winners of the mBillionth Award South Asia.
Publications
- [[Ford|Ahsan, A., & Raihan,
A. (2013, December). Understanding mHealth impact among Aponjon (MAMA Bangladesh) subscribers through a phone survey in Bangladesh. In ]]Proceedings of the Sixth International Conference on Information and Communications Technologies and Development: Notes-Volume 2 (pp. 1–4). ACM. URL: http://dl.acm.org/citation.cfm?id=2517920&dl=ACM&coll=DL&CFID=539198654&CFTOKEN=40545154
- [[Ford|Alam, M., Raihan, A., & Ahsan, A.
(2012). Improving health awareness through mobile based health messages in Bangladesh. Journal MTM, 1(4S), 23-24. URL: http://www.journalmtm.com/2012/improving-health-awareness-through-mobile-based-health-messages-in-bangladesh/]]
- Rajan R. et al., (2013)MAMA “APONJON” Formative Research Report, Baltimore Maryland Johns Hopkins University Global mHealth Initiative. URL: http://www.mobilemamaalliance.org/sites/default/file/MAMA%20Bangladesh%20Formative%20Research%20Report.pdf