The monthly Village Health Sanitation and Nutrition Day (VHSND) is always crowded with women and kids who come for health checks and immunisations. They come in droves for this last mile government health outreach programme, conducted by an Auxiliary Nurse Midwife (ANM). The Community Health Workers (CHWs) have recently been trained to add a new feature to VHSND’s health communications and services delivery platform: ‘Gupshup Potli’ (A bagful of conversations).
The ANM, Kamla, lays out her equipment—stethoscope, tablets, blood pressure machine, and scales. She sets about immunising and weighing kids, and answering women’s questions. During the half-hour observation period after vaccination, she nods at the AWW to start the new communication, as she herself is still busy distributing tablets.
The AWW connects her mobile phone to a speaker via an auxiliary cable. She dials a toll-free number to access Gupshup Potli, and the speaker broadcasts a health message. This one is about how discussion between husbands and wives makes family planning easier and more effective. After the play-out, the AWW uses cue cards to start a discussion and address questions. Young mothers in the audience, like Gauri, who is already a mother of two and pregnant with a third child, will hopefully carry the discussion forward at home.
The next month, at the next VHSND event, Gupshup Potli will broadcast a different normative health message that will trickle down to the entire village community. Like Gauri, many people will talk about the Gupshup Potli message with their mothers-in-law, husbands, other family members and friends. The service aims to stimulate conversations that serve as a gateway to large-scale behaviour change, generating further health awareness and reach.
In order to make Gupshup Potli heard above the noise of the crowd, BBC Media Action distributes hardware – in this case, speakers and cables that fit varying kinds of mobile phone jacks, and trains CHWs to use them.
Leveraging simple, pervasive technology like mobile phones and existing infrastructure has allowed Gupshup Potli to piggyback on the well-established VHSND platform. For roughly the cost of a disposable syringe, it generates potentially large-scale health awareness, and demand for health services, without affecting the VHSND’s workflow, mandate, and objectives. It is flexibly designed to serve local context, and to accommodate the work division between ANMs, who are custodians of the output, and AWWs, who are also trained to operate the hardware. Gupshup Potli is also aligned with government monitoring and reporting systems.
Gupshup Potli sparks family and social conversations. And there’s nothing like group conversation to spread an idea—or a bagful of ideas.
The Village Health Sanitation and Nutrition Day (VHSND) programme offers last-mile outreach for the public health system. Often held at a village Anganwadi Centre, and conducted by an Auxiliary Nurse Midwife (ANM), it is an opportunity of bringing health communication right to the point of service delivery.
The ‘'Gupshup Potli'’ connects ANMs’ existing mobile phones to portable, battery-powered speakers. Once connected, ANMs dial a Toll Free number on their phones to play audio health content. With this simple hardware, it overcomes the challenge of broadcasting family health messages to people with limited mass media access.
The 'Gupshup Potli' hardware – a small, powerful speaker with long battery life that can be plugged into almost any mobile phone - is simple enough to be operated by relatively low-tech users in a rural context.
An ANM checks out her 'Gupshup Potli' hardware received at a training event. The ANMs, the custodians of VHSND events, feel that this new method of communication will help her more effectively counsel the women.
The messages broadcast through 'Gupshup Potli' are designed to trigger conversations facilitated by health workers (with the help of a cue card). Since VHSNDs are mostly attended by pregnant women and mothers, 'Gupshup Potli' offers accurately targeted reach. These conversations can act as a gateway to large-scale behaviour change.
A flexible operating model is one of the key aspects of 'Gupshup Potli'. Although an ANM is the custodian of its hardware, it can be operated by any of the health workers – an ANM or an Anganwadi Worker – depending on who is free at the time.
An ANM is busy preparing the 'Gupshup Potli' report. Integrating it with the regular public health reporting system helps institutionalise the medium.