Although Bangladesh has made large strides with regards to improving maternal, newborn and child health (MNCH) outcomes, it must continue to steadily decrease mortality to achieve the 2015 Millennium Development Goal targets. It is essential that Bangladesh leverage existing and new methods and tools to reach the women and families who are most in need. Of every 100 people living in Bangladesh, just 55 have access to sanitation services, while 64 have mobile phone subscriptions. This confluence of factors — high mobile penetration and a need to improve MNCH outcomes — signifies that MAMA offers a great deal of potential.
The MAMA Bangladesh program is called Aponjon, which means ‘the close/dear one’ in Bangla. After a year of pilot testing, Aponjon was launched nationally in December 2012 by Bangladeshi social enterprise, Dnet, in partnership with the Government of Bangladesh Ministry of Health and Family Welfare. To support this work, Dnet also brokered partnerships with six outreach organizations, five mobile network operators, and three corporate partners. Since launching, it has grown to serve more than 500,000 mothers and families and trained over 3,000 community agents and brand promoters who raise awareness of the service and assist subscribers in signing up.
Information is delivered twice weekly in one of two forms: SMS, or 60-second voice messages. The voice messages are a mix of “mini-skit” messages, with local actors playing the roles of a doctor, pregnant woman, mother and mother-in-law; and direct messages. In the dramatic format, characters enact scenarios in an entertaining and educational way. Dialogues range from the doctor explaining the importance of iron-rich food, to reminding the pregnant character that it is time for her medical checkup. Messages around medical emergencies and warning signs that something may be wrong are in the direct, straightforward format.
Dnet also created a unique service specifically for husbands and other household members to reinforce messages provided to the mother and encourage family involvement in healthy decision making around pregnancy, birth and infant care. This service adds one additional message per week, increasing the total from two to three. Dnet also offers a counseling line to subscribers which serves as a way to directly communicate with a doctor about specific health problems.
MAMA Bangladesh relies on multiple revenue streams, including donor funding, corporate partnerships, mobile operator discounts and user fees. The Aponjon service, which costs two taka (approximately 2.5 US cents) per message, aims to provide the messages free to at least 20 percent of the poorest subscribers and is exploring the development of higher-end apps for upper-income audiences that could help cross-subsidize the basic service for the poorest mothers in Bangladesh.
MAMA Bangladesh is implemented by Dnet, a social enterprise. Dnet has secured a number of critical partnerships that span government agencies, telecommunications operators, outreach partners, and the private sector.
For more information about the MAMA Bangladesh country program, please visit www.aponjon.com.bd.
“This is your doctor (daktar apa) speaking. You need plenty of iron for your baby to grow well. Having enough iron will also help reduce the amount you bleed at birth.
Please listen carefully. Taro stems, cauliflower, spinach, red gram lentils, eggs, chicken meat, liver and fish contain iron. Lemon, oranges and grapes will help your body absorb the iron. Also take iron tablets regularly along with your meals.”
“I was nervous about the birth of my second child but the messages helped me understand what to expect and how to care for her. I have learned many things I didn’t know when my first child was born.”
Asha Rani, Aponjon subscriber