PHNOM PENH (Khmer Times) – Dr. Thearith helps thousands of women in Kampong Chhnang province care for their babies. He provides them with advice about how to breastfeed, how to keep their infants from contracting malaria, and how to avoid infections.
Dr. Thearith, however, does not exist. He is a character in “radio dramas” that Czech NGO People in Need (PIN) Cambodia delivers to the cell phones of new mothers in Kampong Chhnang. The initiative is part of a mobile health campaign aimed at reducing Cambodia’s high infant mortality rate.
According to the World Bank, 33 in 1,000 Cambodian children died before their first birthday in 2014, almost double the infant mortality rate in Vietnam and triple the rate in Thailand. Many of these deaths were preventable, but mothers are uneducated about nutrition, and often delay taking their child to the health center until it is too late.
PIN decided it was time for a new approach to reducing infant mortality. “High-resource health promotion projects have been done to death,” Ms. Yuen said. “But [the voice message program] can be highly effective and run very cheaply. You can also target your audience very well.”
PIN introduced the voice message program for neonatal care in January 2014, and plans to expand it dramatically next month. Now, when mothers in Kampong Chhnang give birth at one of the province’s public clinics or hospitals, the midwife asks if they want to register to receive the messages. In the last year and a half, 7,246 women have signed up.
The voice message program has changed their behavior for the better. Compared to a control group, women who received the messages were 30 percent less likely to drink alcohol after birth than women in the control group. They were also 25 percent less likely to participate in “roasting” – a tradition meant to ward off evil spirits by forcing new mothers to lie on beds over fire for several days that leaves them dehydrated and ill.
Fun, Chatty Approach
Voice messages have a unique reach compared to other education methods. Even in the most rural provinces of Cambodia, most women have access to a cell phone. Since literacy rates in rural Cambodia are still low, and since many phones don’t support Khmer script, the voice messages are easy for the women to access and understand than text messages.
PIN has recorded 150 messages, which are delivered automatically to thousands of cell phones every week. Unlike most other health programs, PIN has tried to make its messages fun. “Communities in Cambodia are really overloaded with these messages,” Ms. Yuen said. “The health promotion is often didactic, dry, boring.” But PIN’s messages are in the style of radio dramas, with a colorful cast of characters, sound effects, and joking banter.
The phone rings, and when the mother answers she hears a greeting – such as “Hello! Grandma Seam here from Healthy Family Community!” – followed by a short explanation of proper hygiene or debunking of harmful traditional medical practices.
Midwives are the best evangelists for the program, introducing new mothers to it and encouraging them to sign up. “Sometimes, mothers can forget to take care of their babies,” said midwife Chan Ratana, who works at Taches health center in Kampong Chhnang. “When they get this voice message, it reminds them.”
Now PIN plans to expand the program to Phnom Penh and other provinces. They also plan to increase the number of messages, so that mothers receive information from early pregnancy until their child’s second birthday.
Ms. Yuen hopes to have 10,000 mothers registered by the end of the year.