Voice and text messages help women in Bangladesh make contraceptive choices, study finds

Tuesday, March 20, 2018

person using phone

Public health organizations are increasingly using mobile health (mHealth) interventions to target specific audiences with personalized health information. In Bangladesh, an Ipas study used mHealth messaging to determine what family planning information women want to receive after having a safe abortion (known as “menstrual regulation” in this country).

Government health guidelines recommend women receive family planning services after menstrual regulation, however a Guttmacher Institute study found little evidence that women actually receive contraceptives.

Ipas’s study found the majority of women were open to receiving messages on their mobile phones and talking to a counselor about family planning methods over the phone after menstrual regulation.

The majority of women preferred voice messages over text and were receptive to the interactive voice message format. Their preference for voice messages over SMS suggests rural and less educated women—who are more likely to be illiterate—may have difficulty reading text messages.

The study also found women wanted information on the contraceptive they were currently using, what methods they could use after their menstrual regulation procedure, and what method would best suit them.

Women found the information they received valuable because they could share it with other women in their family and community, as well as with their husbands--which provided an important way of involving men in family planning decisionmaking.

“We hope that findings from this study will be used to guide other mHealth programs for post-menstrual regulation contraceptive use in Bangladesh and provide these with insight into what types of messages women wanted to receive, and what information about contraception their found useful” says Elisabeth Eckersberger, lead author and senior advisor at Ipas.

The researchers conducted participatory interviews with 24 menstrual regulation clients to find out what information and support women wanted after the procedure and what was the best way for the women to receive the information.

An interview guide was developed in English and translated into Bengali. The guide was pilot tested through peer testing and adapted during the interviewer training. During the interviews women were shown and played six different messages — two reminders about oral contraceptive pills and injectables, two factual messages on the effectiveness and side effects of the IUCD, and two personal stories about women’s experience of using oral pills or the IUCD.

The mobile phone messages were delivered by SMS in phonetic Bengali with English letters as the mobile phones do not feature Bengali script, voice messages in Bengali and interactive or one-way messages.

For the one-way message and interactive messages an automated message was played after the phone was picked up. At the end of the interactive messages the participant could choose from a number of options by pressing a number on the key pad.

Ipas research generates new knowledge for the larger reproductive health and rights community. We also focus on targeted research to understand more about women’s needs and wants regarding reproductive health care and how they make decisions about contraception and abortion.