A Mobile Tool for Health Workers: Promising Results in Bihar, India
Bill & Melinda Gates Foundation
- Beneficiaries in treatment areas were more likely to receive frontline worker home visits than those in control areas.
- Home visits by frontline workers in the treatment areas appear to be of higher quality.
- The intervention had significant impacts on beneficiary health behaviors, especially those related to antenatal care, child nutrition, and reproductive health.
We conducted a clustered randomized controlled trial of an innovative mobile-phone based tool designed to improve service provision by frontline health workers (FLWs) in the state of Bihar, India. This Information Communication Technology Continuum of Care Services (ICT-CCS) tool allows FLWs to electronically schedule and coordinate home visits, track beneficiaries, and record health information. Other features include interactive checklists and informative videos, while supervisors also received a version of the tool designed to improve their oversight of FLWs. The intervention was added on to a package of services provided to beneficiaries. Surveys of beneficiaries (mothers of infants) and FLWs conducted about two years after implementation began suggest that that the introduction of the ICT-CCS intervention significantly improved coordination among FLWs and increased the share of women visited by an FLW at key points in time. The intervention also significantly affected several important beneficiary health behaviors, with effects concentrated in measures of antenatal care, nutrition, and reproductive health. These strong impacts were observed despite the fact that some features of the tool were not utilized to the extent envisaged and that FLWs experienced technical and logistical challenges in using the tool—suggesting that there may be potential for even stronger impacts.