1

Marie Stopes International Cambodia

MOTIF: MObile Technology for Improved Family Planning

Presented by: Hotline Manager

Contents

2

• Overview• What is MOTIF?• Objectives• Project Activities• Process• Evaluation and Outcomes• Lessons Learned & Recommendations

Overview

3

Challenge: Low uptake of contraception following abortion, with clients returning for repeat abortion

MOTIF

4

MOTIF (Mobile Technology for Improved Family Planning) is

an innovative mobile phone-based intervention, providing personalized post-abortion family planning (PAFP) support for Marie Stopes

International Cambodia (MSIC) clinics.

Objectives

5

• To reduce unmet need for PAFP and decrease discontinuation rates of FP, to have a positive impact on the lives of women in Cambodia and on MSIC’s work.

• To develop, implement and evaluate a mobile phone-based intervention to support use of post abortion family planning (PAFP) at Marie Stopes International Cambodia (MSIC) clinics.

Project Activities

6

MOTIF is a voice based intervention service• Formative research to develop service• Baseline rates of PAFP• Interviews/Focus group discussions(FGDs)

The project had conducted a randomized controlled trial to evaluate the service

1. Recruitment of clients2. Communication guidelines have been developed with clients and phone counseling is being provided .

Client recruitment

Client recruitment

Client FGD

MOTIF Verboice Call Flow

7

Counselors Client

VM every 2 weeks

+/- follow up phone call

Pill/appointment reminders

Client can call in

Service provided for 3 months after which client continue to receive standard care

Evaluation Process

Intervention

9

500 clients seeking for abortion services

249 clients who received MOTIF service

Area of Scope

64% of clients lived inrural areas

86% receivedfollow up servicefor 4 months

Voice Message

11

Responses to Voice Message

12

Provisional results to date• Percentage of MOTIF supported clients using effective contraception

before and after receiving the intervention (data from the counsellors)

Implant IUD Injectable Pill

7%

3%

8%

12%

15%

10%

15%

21%

MOTIF supported clients using effective contraception receiving the intervention (Data from the counselors)

% Base line % End line

Please note: the trial data & cost-effectiveness has not yet been analyzed

Lessons learned / Challenges

• Two-way communication and regular contact with clients

- Follow up

- Promote MSIC clinics’ services

- Disseminate MSIC promotional

- On going support clients

• Reduction on resources such as time, staffing and finances

• Clients have a broad range of choices

14

Lessons learned / Challenges

• Voice messages take much longer to develop compared to SMS

• Connecting to a phone line than can handle multiple calls

• Connecting with clients– SIM card switching– Phone sharing– Clients busy

• Financial sustainability

Conclusion

• Maintain sight of the original challenge e.g. increasing PAFP uptake rather than focusing on the ‘tech’ component

• A formative research phase is essential to understand the local context

• Selection of the tech partner is crucial - a local partner is preferable

Conclusion

• Additional mobile phone based support should not be provided in place of the existing standard of care, which include post-abortion counselling. mHealth PAFP interventions should be considered as part of an integrated package of post-abortion care

• Voice messages are a good way to communicate with clients with limited literacy and to clients with phones that don’t support local language script

Recommendations for Verboice

• Email notifications for every client’s response

• Avoid repeat registration for same number • Automatic resending for internet/server

interruption

18

Next Step

19

+ MOTIF =Customer Care+

Acknowledgments

• MSI Innovation fund• LSHTM• MSIC• InSTEDD iLab Phnom Penh• Verboice• Clients/staff at MSIC

THANK YOU!

ANY QUESTIONS?20

For further information

chris.smith@mariestopes.org.khsreymom.em@mariestopes.org.kh