The Light of Knowledge: A Family Planning Counseling App for Community Health Workers in India
I attended the Global mHealth Forum and mHealth Summit in November, just outside of Washington D.C. Being somewhat new to mHealth, the Forum gave me the opportunity to see the various ways mHealth can propel the world of global health and serve as a unique tool to expand access, improve health promotion, strengthen service delivery, and change behaviors around the globe.
I was especially intrigued by presentations that demonstrated the power of mHealth in driving health care utilization and service delivery. One application of mHealth that stood out as a tool to support health workers as they counsel women on contraceptive options was Gyan Jyoti.
Implemented by the Johns Hopkins Center for Communication Programs (CCP), Gyan Jyoti, which means “Light of Knowledge” in Hindi, is a self-learning, counseling, and monitoring app used by Accredited Social Health Activists (ASHAs), or government-trained frontline health workers, in India. The app couples persuasive audiovisual information on reproductive health and modern contraceptives with the power of interpersonal counseling to increase the adoption of modern contraceptive methods among couples in Bihar, India. The ASHA is able to bolster her knowledge of family planning and improve her counseling skills through the mobile learning (mLearning) feature. During counseling sessions, the app provides easy access to high quality, engaging, and educational content designed to support positive decision making for family planning. An added benefit is the platform’s ability to monitor activities that occur within the app and provide a means for ASHAs to input, store, and access client information. Gyan Jyoti provides ASHAs with several resources to use during family planning counseling sessions with their clients, including the following:
- Correct and credible technical information on available modern contraceptive methods
- A mix of thoughtfully produced family planning films, including expert explanations by doctors, real testimonials, entertainment films, and TV advertisements
- A list of frequently-asked questions and guidance on next steps for choosing a method
A five-month proof of concept study compared the family planning uptake among married women counseled by ASHAs equipped with Gyan Jyoti to a separate group of married women exposed to ASHAs equipped with an SD phone card only. In both arms of the study, the mobile technology use (Gyan Jyoti app and the SD card) contained similar audiovisual films, which all ASHAs were encouraged to use during counseling sessions with family planning clients. However, in the case of Gyan Jyoti, ASHAs received additional training on how to navigate the content to enhance counseling. In addition, the Gyan Jyoti app organized content in an intuitive format and included additional how-to sections, which provided guidance on technical family planning information for the ASHAs' personal edification.
There were several interesting findings:
- Women counseled by ASHAs equipped with the Gyan Jyoti app were 4.5 times more likely to use a modern method of contraception compared to women exposed to ASHAs equipped with an SD card only.
- Women who received counseling with the app were 1.5 times more likely to report as a current user of modern family planning than women exposed to ASHAs equipped with an SD card only.
- Also of importance, ASHAs themselves were almost 15% more likely to show family planning audiovisual content packaged as Gyan Jyoti as compared to content organized on an SD card.
In communities where ASHAs often serve as one of the first contacts for health information, tools such as Gyan Jyoti can provide ASHAs with the instant knowledge, increased credibility, and improved confidence they need to provide accurate family planning information to clients. I’m looking forward to seeing where apps like Gyan Jyoti and others are used in the future and their impact on the lives of women and families around the world.