Global Health Science & Practice: Successful mLearning Pilot in Senegal: Delivering Family Planning Refresher Training Using Interactive Voice Response and SMS

I was interested to read this paper in the open-access journal Global Health Science and Practice (isn’t it wonderful that papers relevant to HIFA seem to be increasingly, indeed mostly, open access?). The authors found that knowledge increased post-intervention. But perhaps what is more important is how the intervention compares with other interventions. Indeed, even if an intervention were ineffective, might one expect participants to acquire increased knowledge simply because they know they will be tested? I note that a few HIFA members are among the authors and look forward to their comments.

‘Health workers’ knowledge of contraceptive side effects increased substantially after the refresher training. The mobile phone approach was convenient and flexible and did not disrupt routine service

delivery. Clear limitations of the medium are participants can’t practice clinical skills or have interactive discussions. Also, some participants had trouble with network reception.’

CITATION: Successful mLearning Pilot in Senegal: Delivering Family Planning Refresher Training Using Interactive Voice Response and SMS

Abdoulaye Diedhiou, Kate E. Gilroy, Carie Muntifering Cox, Luke Duncan, Djimadoum Koumtingue, Sara Pacque-Margolis, Alfredo Fort, Dykki Settle, Rebecca Bailey.

http://www.ghspjournal.org/content/early/2015/06/01/GHSP-D-14-00220.full.pdf+html

ABSTRACT

Background: In-service training of health workers plays a pivotal role in improving service quality. However, it is often expensive and requires providers to leave their posts. We developed and assessed a prototype mLearning system that used interactive voice response (IVR) and text messaging on simple mobile phones to provide in-service training without interrupting health services. IVR allows trainees to respond to audio recordings using their telephone keypad.

Methods: In 2013, the CapacityPlus project, funded by the US Agency for International Development, tested the mobile delivery of an 8-week refresher training course on management of contraceptive side effects and misconceptions to 20 public-sector nurses and midwives working in Me´khe´ and Tivaouane districts in the Thie`s region of Senegal. The course used a spaced-education approach in which questions and detailed explanations are spaced and repeated over time. We assessed the feasibility through the system’s administrative data, examined participants’ experiences using an endline survey, and employed a pre- and post-test survey to assess changes in provider knowledge.

Results: All participants completed the course within 9 weeks. The majority of participant prompts to interact with the mobile course were made outside normal working hours (median time, 5:16 pm); average call duration was about 13 minutes. Participants reported positive experiences: 60% liked the ability to determine the pace of the course and 55% liked the convenience. The largest criticism (35% of participants) was poor network reception, and 30% reported dropped IVR calls. Most (90%) participants thought they learned the same or more compared with a conventional course. Knowledge of contraceptive side effects increased significantly, from an average of 12.6/20 questions correct before training to 16.0/20 after, and remained significantly higher than at baseline 10 months after the end of training at 14.8/20, without any further reinforcement.

Conclusions: The mLearning system proved appropriate, feasible, and acceptable to trainees, and it was associated with sustained knowledge gains. IVR mLearning has potential to improve quality of care without disrupting routine service delivery. Monitoring and evaluation of larger-scale implementation could provide evidence of system effectiveness at scale.

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

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