ICTworks

The Mobile Alliance for Maternal Action (MAMA) approach uses age- and stage-based messaging directed toward pregnant women, new mothers and families to foster behavior change and improve maternal and child health outcomes.

What are the lessons learned from implementing the MAMA approach in Bangladesh, South Africa, India and Nigeria?

Twenty-five representatives from the four country programs and core partner organizations used the mHealth Assessment and Planning for Scale toolkit to developed common program implementation lessons based on broad themes identified by the country leaders.

Four Lessons Learned in Implementing MAMA

Reading the Lessons from Implementing the MAMA Programs, I found four operational lessons that country program implementers learned as they overcame implementation challenges.

1. Formative research is essential

There is no substitute for informing service design (including choice of timing and frequency of messages, separate content for gatekeepers, and differential of urban vs. rural services). Programs must invest in formative research to design successful programs.

2. Content must be hyper-localized

Content needs to reflect local practices, myths, home remedies, dialects, terminology, and national standards. Localization through in-country stakeholders of global content is key, as is providing them with the capacity to continuously improve content.

3. MNOs are key and difficult

Use of mobile aggregators with existing telco relationships and connectivity (if available) are essential for getting to get to market quickly, but at scale they can be costly, hard to control and ineffective in holding mobile network operators to commitments. Partnership structure must be established from the start, with clear roles.

4. Use multiple business models

Use a variety of business models to sustain funding and cover costs, including government funding and user fees, and yet realize that utilizing human intermediaries (community health workers, NGO agents, brand ambassadors) to enroll subscribers will create major challenges in covering costs of training and incentives payment at scale.

These Lessons Learned Are Universally Applicable

These lessons learned provide valuable insight into the implementation processes of the four country programs. Yet the lessons have wide applicability across international development.

Each of these lessons could apply to any digital health program – including yours.

Digital health is still an emerging area, and it is essential for implementers to continue to share their experiences and contribute to the evidence base, particularly how they impact behavior change, service utilization, and health outcomes.