1. texttochange.com @texttochange

2. Mobile technology for Sexual and Reproductive Health TTC tools and learnings Arjen Swank – Programme Manager E-Mail: arjen@texttochange.com Twitter: @arjenswank http://www.texttochange.com

3. What do we use our mobile phone for these days?

4. SMS is now the world's most intensively used data communication technology. Total SMS sent globally tripled between 2007 to 2011 from 1,8 to 6,4 trillion. In 2016 : 9,4 trillion! Close to 200,000 text messages are sent every second! In 2011: 4,2 billion, 65% of world population, active users of SMS text messaging. It is also double the number of internet users, 5 times the number of Facebook members.

5. Over 1 billion people in Africa 53% has a mobile subscription 1 million new subscribers per month Over 48 million people have a mobile phone, but no electricity Next year an estimated 1,7 billion people will have a mobile phone, but no bank account 95% of messages is read; 90% within 4 minutes HOW DO YOU THINK THIS WORKS FOR AFRICA?

6. Short introduction to TTC: http://youtu.be/4_A0wfTD1lohttp://youtu.be/4_A0wfTD1lo Since 2008 TTC is an established, leading and pioneering social enterprise that builds simple and scalable mobile solutions (SMS, Voice, Feature- and Smartphone Apps) for hard-to-reach audiences to improve their health and wellbeing. We set up tailor-made, interactive and incentive based mobile programs in 17 countries in Africa and South-America. We are a social mobile service & content provider Average 65% participation rate in campaigns

10. What is M4RH? Mobile technologies identified as an important area to explore for innovative Family Planning communication. Set of text messages developed by FHI360 on contraceptive methods and based on World Health Organization medical eligibility criteria (WHO MEC). Technology platform developed by Text to Change and maintained through relationships with mobile operators. mHealth system that is easily incorporated and adaptable to existing reproductive health programs.

11. How does m4RH work? Welcome to M4RH free info service. For implants reply 11, IUD 21, permanent 31, injectable 41, pills 51, EC 61, condoms 71, Natural Family Planning 81, Clinic finder 91. Advantages Private medium but easily shared Trustworthy (information WHO based and pre-tested) Easy to set up – sharable, scalable, replicable Multiple focus groups Multiple languages Advantages Private medium but easily shared Trustworthy (information WHO based and pre-tested) Easy to set up – sharable, scalable, replicable Multiple focus groups Multiple languages Countries 2011-2013 Kenya Tanzania Ghana Countries 2011-2013 Kenya Tanzania Ghana

12. KeywordContent # of queries KenyaTanzania m4RHMain Menu11,691175,641 00, 01, 02, 03Secondary Menus4,205119,700 11Implants2,28216,473 21IUDs1,99313,481 31Permanent Methods1,43819,190 41Injectables2,00714,816 51OCPs2,37215,479 61Emergency Contraception1,95823,925 71Condoms2,93527,920 81Natural Methods3,90334,605 99ALL METHODS2,59037,249 91Clinic Locations1,84219,298 Total Hits39,215517,777 Information Accessed Through m4RH per month

13. Setup of m4RH+ Treatment group + control group Different information about reproductive health through Wikipedia- style SMS menu-driven system Content difference between two groups Evaluation after dedicated periods through SMS questionnaire Measurement of differences in attitude and knowledge towards reproductive health and family planning Evaluating m4RH

14. (re-) consider your resources Set realistic timelines – something always comes up Involve right mix of communication channels Combine broadcasting through traditional media (radio, newspaper, poster) and narrowcasting with new media (Mobile) Get your context right Needs and communications assessment Research the Local factors Technology is a tool, not a goal in itself Incentives work Lessons learnt:

15. Mutual understanding with mobile operators Working with partners – mobile scepticism Basic health systems are not functioning Sustainability / business model(s) Impact measurement Challenges:

16. 1. Understand where and with who you work 2. Comprehensive program design takes time 3. Impact only comes with partnerships. Stick to your expertise and allow commercial partners/sponsors. Search for synergies 4. Plan multiple moments for M&E. Be flexible and adjust where required. 5. Keep it simple! Main recommendations Successful mHealth projects in Africa are: Accessible Relevant (Near) free

17. Thank you Ideas, suggestions, questions? Want to try it yourself? Text m4rh to +31642500021 Arjen Swank Programme Manager arjen@texttochange.com Mobile: + 31623787595 http://www.texttochange.com