New Publication Spotlight: Use of an Interactive Voice Response System to Deliver Refresher Training in Senegal

For the 222 million women who have an unmet need for modern contraception, increasing access to high-quality family planning services is essential.

As countries work to scale up the number of health workers, it also makes sense to focus on the existing workforce. In-service training can improve the quality of family planning services by updating health workers’ knowledge, but it is often expensive and requires providers to leave their posts during the training.

CapacityPlus developed, deployed, and assessed an innovative mLearning system to deliver refresher training to family planning providers, focusing on management of contraceptive side effects and counseling to dispel misconceptions. The pilot application among 20 midwives, nurses, nursing assistants, and health agents took place in Meckhé and Tivouane districts in Thiès Region, Senegal.

Publication coverA new publication, Use of an Interactive Voice Response System to Deliver Refresher Training in Senegal: Findings from Pilot Implementation and Assessment, shows how the mLearning system delivered training via simple mobile phones and was found to be feasible, well-liked by participants, and associated with sustained gains in knowledge.

Interactive voice response (IVR) is a technology—possible with any type of phone—that delivers information via audio recordings and allows users to provide feedback by pressing a number key. IVR allows for the delivery of more robust information than SMS text and doesn’t require smartphones, Internet connectivity, or even full literacy.

The training content, 20 multiple-choice and true-false questions and detailed explanations, was aligned with Senegal’s national family planning policies and international guidelines. Each trainee specified a time of day to receive a daily SMS text reminder to prompt a call. Whenever the trainee was ready, he or she texted the mLearning system to prompt a call, then responded to audio-recorded questions using the phone’s keypad. The system indicated whether the answer was correct or incorrect and provided a detailed explanation via audio recording.

Phone showing text from mLearning courseAfter trainees answered all 20 questions, they received the same questions and explanations a second time. Once a trainee answered a question correctly twice, the question was retired and not asked again.

All 20 participants completed the course, with the majority completing it within five weeks. Trainees prompted the majority of calls outside of normal working hours. They reported that the overall experience of using a mobile phone to complete in-service training was either very good (65%) or good (35%). A large majority strongly agreed that the course improved their knowledge and helped them provide better services to their clients. Their knowledge of contraceptive side effects and misconceptions significantly increased from an average of 12.6 questions correct before the training to 16 out of 20 after the training.

The IVR mLearning platform has the potential to be an effective and efficient means of providing refresher training and/or updates to national guidelines, policies, and protocols. It is especially well suited to reach health workers in rural and remote settings.

A family in Thiès, Senegal, after receiving their mosquito net. © 2012 Diana Mrazikova/Networks/Senegal, courtesy of Photoshare“This training was timely and helped us solve recurring problems in the area of family planning, especially in the management of myths and rumors,” said Dr. Pape Ibrahima Camara, district medical officer in Tivaouane District, Thiès Region. “This program should be scaled up in order to reach more health workers.”

The new publication provides recommendations for adapting and scaling up the mLearning system to other topics and geographic areas in Senegal and beyond.

CapacityPlus submitted results from the pilot for the fourth edition of the USAID mHealth Compendium, and presented these results at the GETHealth Summit and the Global mHealth Forum. A paper has been accepted by the journal Global Health: Science and Practice.

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Photo 1 courtesy of Kate Gilroy. Photo 2: A family in Thiès, Senegal, after receiving their mosquito net. © 2012 Diana Mrazikova/ Networks/Senegal, courtesy of Photoshare