0239 - Traversing the last mile to reach excluded children with vitamin A Supplementation (VAS): use of mHealth strategy for improved coverage in geographically difficult terrain
Jharkhand is a conflict ridden state in India with a difficult geographical terrain. Innovative approaches, using mobile short message service (SMS) to gather real time reports from VAS sites, and portable media players for community mobilization, in geographically excluded areas affected by civil strife, were introduced to increase access to VAS.
UNICEF partnered with government and non-governmental organizations (NGOs) to reach out to the most excluded deprived communities. A state-wide mapping of routine health sites was conducted to identify hard to reach (H2R) villages with no health facilities. Volunteers equipped with portable MP3 players disseminated pre-recorded messages on VAS to educate and mobilize the community to attend the biannual VAS. NGO volunteers monitored the H2R sites and sent real time SMS on the number of children receiving VAS at the actual session sites.
Real-time monitoring reported high coverage (98%; 2052 sessions out of 2087) of VAS in H2R villages. For the first time, 99,064 (out of 128,759) children benefitted from VAS in areas with civil strife. More than 63% (1,300) of the H2R villages reported coverage of >80%. The average cost per child was USD 31, which comprised of routine costs, including communication and monitoring components.
The use of mHealth strategy using innovative programme communication and monitoring has improved VAS coverage in geographically excluded and civil strife affected areas. The communique in local dialects enhanced community mobilization. Lessons learned has prompted the state government to adopt this strategy as part of future VAS programme.
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