For the past five years a consortium of researchers from Institute of Development Studies (IDS), Gamos and International Food Policy Research Institute (IFPRI) have been evaluating the impact of the mNutrition programme. Led by GSMA and supported by the UK Foreign, Commonwealth & Development Office (FCDO), the programme was a global initiative that aimed to use mobile technology to improve the health and nutritional status of children and adults in low-income countries around the world.
As the evaluation draws to a close, we are delighted to share our final mixed methods reports for the two country case studies in Ghana and Tanzania. Here we asked our consortium researchers, Dr Inka Barnett (IDS, the overall lead and qualitative component lead), Dr Nigel Scott (Gamos, the Business and cost effectiveness component lead) and Dr Dan Gilligan, Dr Melissa Hidrobo and Dr Giordano Palloni (IFPRI, quantitative component) to share a few reflections on what they learnt from the evaluation and what they thought the future holds for digital development programmes.
What is your key takeaway from the evaluation?
Dr Inka Barnett, IDS: Mobile phone-based behaviour change interventions are unlikely to succeed as stand alone features but should be part of a bigger effort (for example integrated in existing services or programmes) and they should be combined with at least some human support features. Individuals engage in different ways with digital behaviour change interventions and ‘effective engagement’ might look very different to engagement seen in other types of interventions.
Dr Nigel Scott, Gamos: There is an important role for a product champion. mAgri tech start-ups typically begin with a small number of entrepreneurs who learn how to adapt quickly and continually develop their product to overcome obstacles as they arise. Any mobile service needs to retain this ethos of product development, as scaling any service brings further challenges. Of course, as a product scales, responsibility for this can be institutionalised rather than depending on a couple of key individuals, but it remains just as important.
The IFPRI team: Despite challenges in promoting take-up and use of the mNutrition platform in Tanzania, access to the service led to more diverse diets among children and increased nutrition knowledge among adult men, who had more access to phones. In Ghana, people were willing to pay a small fee for access to the mNutrition platform, showing that there is demand for quality mobile information services, although subsequent use of the service was low.
In both countries, the presence of the mobile nutrition information component increased users’ connections to their mobile phones, either by increasing loyalty to the service or by increasing use. This supports the business case for such platforms.
What do you think the future holds for the use of mobile technology in terms of influencing behaviour change around nutrition and agriculture?
Dr Inka Barnett, IDS: Mobile phone technology has a role to play, however, I doubt that there is a ‘one size fits all’ mobile intervention that can easily and cheaply change behaviours. Human behaviours are complex and dynamic and influenced by multiple internal and external factors. Interventions need to keep pace with this complexity to be effective. Digital technology has features that could enable this (for example interactive communication, peer-to-peer support, active search functions, highly tailored and responsive content). The challenge that still remains is that many people (and often the most vulnerable, impoverished individuals and women) are, and probably will remain, excluded from digital services in the future.
Dr Nigel Scott, Gamos: I think the current direction of travel evident from emerging services that are more transactional in nature, will achieve greater impacts on agricultural practice. Integrating micropayment technology into agricultural services will open all sorts of opportunities in terms of innovative credit services, access to agricultural inputs, as well as innovations in logistics and produce value chains.
The IFPRI team: The evaluations show that mobile technology can potentially be a useful tool for policy makers interested in affecting knowledge, behaviour and outcomes related to nutrition and agriculture in developing countries. Mobile-based information dissemination is substantially cheaper, can be more easily tailored to individuals, and is more scalable than in-person behaviour change communication and these qualities make it an especially appealing option for reaching remote, rural households. However, mobile phone-based information services are not a magic bullet. They are unlikely to impact overall household resources, the salience of information received through mobile phones is a clear constraint on their effectiveness, and SMS-based messaging is only a feasible approach for literate individuals with easy access to a mobile phone.
What do digital development programmes need to focus on to ensure they are a success?
Dr Inka Barnett, IDS: Thy should focus on improving the reach and uptake of the intervention. This could include design features and implementation procedures that encourage uptake but also broader measurements to address digital exclusion and to improve digital literacy.
Dr Nigel Scott, Gamos: They need to be clear about what the programme is trying to achieve, or more importantly, who the programme is designed to benefit. For example, the evaluation highlighted the many challenges that women face in accessing mobile phone services in rural areas. It also pointed out how different partnership arrangements with mobile network operators can affect reach into under-served communities. So, if the aim is to support the most vulnerable, then any programme will still need to address basic but long-standing issues of coverage, affordability, access to electricity and digital literacy.
The IFPRI team: Digital development programs will need a sustained commitment, quality programming, and flexibility in design to be successful. The evaluation showed that initial roll-outs may fail due to weak consumer awareness and promotion messages that miss the target audience. To improve nutrition and agriculture outcomes, messages must be accurate and clear and should address known knowledge gaps.