Tag Archives: WhatsApp

Using WhatsApp to improve family health

Guest post from ​Yolandi Janse van Rensburg, Head of Content & Communities at Every1Mobile. This post first appeared here.

I recently gave a talk at the MERL Tech 2018 conference in Johannesburg about the effectiveness of Whatsapp as a communication channel to reach low-income communities in the urban slums of Nairobi, Kenya and understand their health behaviours and needs.

Mobile Economy Report 2018. Communicating more effectively with a larger audience in hard-to-reach areas has never been easier. Instead of relying on paper questionnaires or instructing field workers to knock on doors, you can now communicate directly with your users, no matter where you are in the world.

With this in mind, some may choose to create a Whatsapp group, send a batch of questions and wait for quality insights to stream in, but in reality, they receive little to no participation from their users.

Why, you ask? Whatsapp can be a useful tool to engage your users, but there are a few lessons we’ve learnt along the way to encourage high levels of participation and generate important insights.

Building trust comes first

Establishing a relationship with the communities you’re targeting can easily be overlooked. Between project deadlines, coordination and insight gathering, it can be easy to neglect forging a connection with our users, offering a window into our thinking, so they can learn more about who we are and what we’re trying to achieve. This is the first step in building trust and acquiring your users’ buy-in to your programme. This lies at the core of Every1Mobile’s programming. The relationship you build with your users can unlock honest feedback that is crucial to the success of your programme going forward.

In late 2017, Every1Mobile ran a 6-week Whatsapp pilot with young mothers and mothers-to-be in Kibera and Kawangware, Nairobi, to better understand their hygiene and nutrition practices in terms of handwashing and preparing a healthy breakfast for their families. The U Afya pilot kicked off with a series of on-the-ground breakfast clubs, where we invited community members to join. It was an opportunity for the mothers to meet us, as well as one another, which made them feel more comfortable to participate in the Whatsapp groups.

Having our users meet beforehand and become acquainted with our local project team ensured that they felt confident enough to share honest feedback, talk amongst themselves and enjoy the Whatsapp chats. As a result, 60% of our users attended every Whatsapp session and 84% attended more than half of the sessions.

Design content using SBCC

At Every1Mobile, we do not simply create engaging copy, our content design is based on research into user behaviour, analytics and feedback, tailored with a human-centric approach to inspire creative content strategies and solutions that nurture an understanding of our users.

When we talk about content design, we mean taking a user need and presenting it in the best way possible. Applying content design principles means we do the hard work for the user. And the reward is communication that is simpler, clearer and faster for our communities

For the U Afya pilot, we incorporated Unilever, our partner’s, behaviour change approach, namely the Five Levers for Change, to influence attitudes and behaviours, and improve family health and nutrition. The approach aims to create sustainable habits using social and behaviour change communication (SBCC) techniques like signposting, pledging, prompts and cues, and peer support. Each week covered a different topic including pregnancy, a balanced diet, an affordable and healthy breakfast, breastfeeding, hygiene and weaning for infants.

Localisation means more than translating words

Low adult literacy in emerging markets can have a negative impact on the outcomes of your behaviour change campaigns. In Kenya, roughly  38.5% of the adult population is illiterate with bottom-of-the-pyramid communities having little formal education. This means translating your content into a local language may not be enough.

To address this challenge for the U Afya pilot, our Content Designers worked closely with our in-country Community Managers to localise the Whatsapp scripts so they are applicable to the daily lives of our users. We translated our Whatsapp scripts into Sheng, even though English and Kiswahili are the official languages in Kenya. Sheng is a local slang blend of English, Kiswahili and ethnic words from other cultures. It is widely spoken by the urban communities with over 3,900 words, idioms and phrases. It’s a language that changes and evolves constantly, which means we needed a translator who has street knowledge of urban life in Nairobi.

Beyond translating our scripts, we integrated real-life references applicable to our target audience. We worked with our project team to find out what the daily lives of the young mothers in Kibera and Kawangware looked like. What products are affordable and accessible? Do they have running water? What do they cook for their families and what time is supper served? Answers to these questions had a direct impact on our use of emojis, recipes and advice in our scripts. For example, we integrated local foods into the content like uji and mandazi for breakfast and indigenous vegetables including ndengu, ngwashi and nduma.

Can WhatsApp can drive behaviour change?

The answer is ‘yes’, mobile has the potential to drive SBCC. We observed an interesting link between shifts in attitude and engagement, with increased self-reported assimilation of new behaviour from women who actively posted during the Whatsapp sessions.

To measure the impact of our pilot on user knowledge, attitudes and behaviours, we designed interactive pre- and post-surveys, which triggered airtime incentives once completed. Surprisingly, the results showed little impact in knowledge with pre-scores registering higher than anticipated, however, we saw a notable decrease in perceived barriers of adopting these new behaviours and a positive impact on self-efficacy and confidence.

WhatsApp can inform the programme design

Your audience can become collaborators and help you design your programme. We used our insights gathered through the U Afya Whatsapp pilot to create a brand new online community platform that offers young mothers in Nairobi a series of online courses called Tunza Class.

We built the community platform based on the three key life stages identified within the motherhood journey, namely pregnancy and birth, newborn care, and mothers with children under five. The platform includes an interactive space called Sistaz Corner where users can share their views, experiences and advice with other mothers in their community.

With a range of SBCC techniques built into the platform, users can get peer support anonymously, and engage field experts on key health issues. Our Responsible Social Network functionality allows users to make friends, build their profile and show off their community activity which further drives overall user engagement on the site. The Every1Mobile platform is built in a way that enables users to access the online community using the most basic web-enabled feature phone, at the lowest cost for our end user, with fast loading and minimal data usage.

Following the site launch in early August 2018, we are now continuing to use our Whatsapp groups so we can gather real-time feedback on site navigation, design, functionality, labelling and content, in order to apply iterative design and ensure the mobile platform is exactly what our users want it to be.

 

IVR, Facebook and WhatsApp: tech and M&E at AfrEA

by Linda Raftree

At the African Evaluation Association (AfrEA) Conference in Uganda on March 29th,  we ran a session on how mobile and social media platforms are being used in monitoring and evaluation processes. Our discussants were Jamie Arkin from Human Network International (soon to be merging with VotoMobile) who spoke about interactive voice response (IVR); John Njovu, an independent consultant working with the Ministry of National Development Planning of the Zambian government, who shared experiences with technology tools for citizen feedback to monitor budgets and support transparency and accountability; and Noel Verrinder from Genesis who talked about using WhatsApp in a youth financial education program.

Using IVR for surveys

Jamie shared how HNI deploys IVR surveys to obtain information about different initiatives or interventions from a wide public or to understand the public’s beliefs about a particular topic. These surveys come in three formats: random dialing of telephone numbers until someone picks up; asking people to call in, for example, on a radio show; or using an existing list of phone numbers. “If there is an 80% phone penetration or higher, it is equal to a normal household level survey,” she said. The organization has list of thousands of phone numbers and can segment these to create a sample. “IVR really amplifies people’s voices. We record in local language. We can ask whether the respondent is a man or a woman. People use their keypads to reply or we can record their voices providing an open response to the question.” The voice responses are later digitized into text for analysis. In order to avoid too many free voice responses, the HNI system can cut the recording off after 30 seconds or limit voice responses to the first 100 calls. Often keypad responses are most effective as people are not used to leaving voice mails.

IVR is useful in areas where there is low literacy. “In Rwanda, 80% of women cannot read a full sentence, so SMS is not a silver bullet,” Jamie noted. “Smartphones are coming, and people want them, but 95% of people in Uganda have a simple feature phone, so we cannot reach them by Facebook or WhatsApp. If you are going with those tools, you will only reach the wealthiest 5% of the population.”

In order to reduce response bias, the survey question order can be randomized. Response rates tend to be ten times higher on IVR than on SMS surveys, Jamie said, in part, because IVR is cheaper for respondents. The HNI system can provide auto-analysis for certain categories such as most popular response. CSV files can also be exported for further analysis. Additionally, the system tracks length of session, language, time of day and other meta data about the survey exercise.

Regulatory and privacy implications in most countries are unclear about IVR, and currently there are few legal restrictions against calling people for surveys. “There are opt-outs for SMS but not for IVRs, if you don’t want to participate you just hang up.” In some case, however, like Rwanda, there are certain numbers that are on “do not disturb” lists and these need to be avoided, she said.

Citizen-led budget monitoring through Facebook

John shared results of a program where citizens were encouraged to visit government infrastructure projects to track whether budget allocations had been properly done. Citizens would visit a health center or a school to inquire about these projects and then fill out a form on Facebook or a website to share their findings. A first issue with the project was that voters were interested in availability and quality of service delivery, not in budget spending. “”I might ask what money you got, did you buy what you said, was it delivered and is it here. Yes. Fine. But the bigger question is: Are you using it? The clinic is supposed to have 1 doctor, 3 nurses and 3 lab technicians. Are they all there? Yes. But are they doing their jobs? How are they treating patients?”

Quantity and budget spend were being captured but quality of service was not addressed, which was problematic. Another challenge with the program was that people did not have a good sense of what the dollar can buy, thus it was difficult for them to assess whether budget had been spent. Additionally, in Zambia, it is not customary for citizens to question elected officials. The idea that the government owes the people something, or that citizens can walk into a government office to ask questions about budget is not a traditional one. “So people were not confident in asking question or pushing government for a response.”

The addition of technology to the program did not resolve any of these underlying issues, and on top of this, there was an apparent mismatch with the idea of using mobile phones to conduct feedback. “In Zambia it was said that everyone has a phone, so that’s why we thought we’d put in mobiles. But the thing is that the number of SIMs doesn’t equal the number of phone owners. The modern woman may have a good phone or two, but as you go down to people in the compound they don’t have even basic types of phones. In rural areas it’s even worse,” said John, “so this assumption was incorrect.” When the program began running in Zambia, there was surprise that no one was reporting. It was then realized that the actual mobile ownership statistics were not so clear.

Additionally, in Zambia only 11% of women can read a full sentence, and so there are massive literacy issues. And language is also an issue. In this case, it was assumed that Zambians all speak English, but often English is quite limited among rural populations. “You have accountability language that is related to budget tracking and people don’t understand it. Unless you are really out there working directly with people you will miss all of this.”

As a result of the evaluation of the program, the Government of Zambia is rethinking ways to assess the quality of services rather than the quantity of items delivered according to budget.

Gathering qualitative input through WhatsApp

Genesis’ approach to incorporating WhatsApp into their monitoring and evaluation was more emergent. “We didn’t plan for it, it just happened,” said Noel Verrinder. Genesis was running a program to support technical and vocational training colleges in peri-urban and rural areas in the Northwest part of South Africa. The young people in the program are “impoverished in our context, but they have smartphones, WhatsApp and Facebook.”

Genesis had set up a WhatsApp account to communicate about program logistics, but it morphed into a space for the trainers to provide other kinds of information and respond to questions. “We started to see patterns and we could track how engaged the different youth were based on how often they engaged on WhatsApp.” In addition to the content, it was possible to gain insights into which of the participants were more engage based on their time and responses on WhatsApp.

Genesis had asked the youth to create diaries about their experiences, and eventually asked them to photograph their diaries and submit them by WhatsApp, given that it made for much easier logistics as compared to driving around to various neighborhoods to track down the diaries. “We could just ask them to provide us with all of their feedback by WhatsApp, actually, and dispense with the diaries at some point,” noted Noel.

In future, Genesis plans to incorporate WhatsApp into its monitoring efforts in a more formal way and to consider some of the privacy and consent aspects of using the application for M&E. One challenge with using WhatsApp is that the type of language used in texting is short and less expressive, so the organization will have to figure out how to understand emoticons. Additionally, it will need to ask for consent from program participants so that WhatsApp engagement can be ethically used for M&E purposes.