Kilkari ('A baby鈥檚 gurgle'), the mobile phone health service launched by 大象传媒 Media Action and the Government of India in 2015, has been found to have saved nearly 14,000 lives, and to contribute to higher reported use of modern, reversible contraceptive methods by women in India - particularly among poorer families.
The findings demonstrate that a small amount of powerful media content 鈥� delivered directly to mobile phones 鈥� can have a significant impact on the health and future of poorer families, even in rural areas.
Ankur Garg, India Country Director for 大象传媒 Media Action, said:
鈥淲e鈥檙e thrilled that this independent impact evaluation has found clear evidence of the importance of media and communication in tackling health challenges at scale. Kilkari has succeeded because it is informed by research and insights into beliefs and understandings about reproductive, maternal, antenatal, newborn and child health, and because our team, working with the Government of India and other partners, applied evidence and learning to test, adapt and fine-tune our approach. We look forward to sharing these lessons learned with the wider sector.鈥�
Kilkari features the warm voice of 'Dr Anita', a character who shares timely and relevant health information with pregnant women, new mothers, and their families from the second trimester of pregnancy until the baby is one year old. The service, which covers a range of reproductive, maternal, neonatal and child health (RMNCH) issues, including childhood immunisations and feeding, can be used on any mobile phone.
Created and launched by 大象传媒 Media Action in Bihar in 2013, as part of our Shaping Demand and Practices project, Kilkari was adopted by India's Ministry of Heatlh and Family Welfare in 2014 and redesigned for a national audience.
Going national
Kilkari was then scaled up with support from the Bill and Melinda Gates Foundation, USAID, the Barr Foundation and the Government of India, which covered all call costs and the cost of hosting the services in a data centre. Between October 2015 and April 2019, the Ministry of Health and Family Welfare and 大象传媒 Media Action worked together to roll out Kilkari to 10 million subscribers in five languages across 13 states.
Kilkari is one of only five mHealth services in the world to reach over one million subscribers, and by far the largest. It was named 鈥楤est mobile innovation for women in emerging markets鈥� in the GSMA Global Mobile Awards (GLOMO) 2019.
Listeners taking action
The independent impact evaluation, including a randomised control trial conducted by the Johns Hopkins Bloomberg School of Public Health, found that more people who listen to Kilkari use reversible contraceptive methods, ask for contraceptive information and know they can get a pregnancy test from their community health worker. More Kilkari listeners than non-listeners also immunise their babies, play a role in deciding when to introduce first foods, and ask community health workers for advice on early childhood development and support programmes.
础尘辞苍驳&苍产蝉辫;迟丑别&苍产蝉辫;别惫补濒耻补迟颈辞苍鈥檚&苍产蝉辫;蹿颈苍诲颈苍驳蝉:&苍产蝉辫;
- Kilkari has saved nearly 14,000 lives (96% child lives and 4% maternal)
- Women who listened to at least 50% of 碍颈濒办补谤颈鈥檚 messages were 24% more likely than non-listeners to get a pregnancy test from community health workers.
- Women who listened to at least 50% of 碍颈濒办补谤颈鈥檚 messages were 25% more likely to know they could ask community health workers questions about family planning; for men, this was 27%.
- Children of parents who listen to Kilkari were 15% more likely to be immunised at 10 weeks;
- Women who listened to Kilkari were 22% more likely to contact community health workers with questions about early childhood development.
- An overall shift in favour of reversible family planning methods was greater among the poorest users, and among those with a male child.
- With an incremental cost per life saved of $392 to $953 USD, Kilkari is a highly cost-effective intervention, according to WHO standards.
大象传媒 Media Action used a human-centred design process, accounting for gender inequalities, constraints and norms, to create Kilkari, by working directly with low-income, rural women with low literacy rates in six states.
This pro-poor, pro-gender lens has helped it reach millions of families, including women from marginalised communities, and in settings where families share mobile phones.
For instance, the service was designed to try the same subscriber several times across four days until the call was answered, to account for dead batteries, broken phones, SIM cards without a balance, and use of the phone by others.
With over 10 million subscribers, Kilkari demonstrates the power of reliable, relatable, timely information in improving the lives and health of families.
Learn more
- Read our Seven Lessons Learned Insight blog about mHealth in India
- Hear from our former India Country Director, Priyanka Dutt, on the power of mobile communication for health
- Read our Kilkari project summary
- Learn more about how Kilkari was scaled up nationally
- Read our practice briefing - Rethinking maternal and child health communication
- Read our policy briefing - Health on the move: can mobile phones save lives
- Read the special supplement about our work in mobile health communication in India in
- Read more about Kilkari's human-centred design
