Pregnant women in rural Bangladesh lack access to the appropriate healthcare services required to have a successful and healthy pregnancy. Without reliable access to well-trained healthcare professionals, women in higher-risk pregnancies can experience higher mortality rates due to delayed care, lack of care, and misinformation. After speaking with Plan Canada to gain an understanding of the health workers’ usage of data and the ways they currently gather this information, we learned the gaps in their process. Currently, community health workers do risk assessments during appointments but can’t interpret this information into recommendations on their own. Instead, this information must travel back to their office and be communicated to medical professionals for interpretation. This causes delays in communication and the creation of important care plans. Information can get lost along the way and takes too long to make an impact for these women. Meanwhile, women have poor access to accurate health information and may proceed with their pregnancy with misinformation that can be dangerous. They also have limited access to health care workers throughout their pregnancy. In order to tackle this issue we looked at developing a more efficient process for the community health workers that are at the forefront of aiding these women, and created a process that empowers them to plan for their pregnancies without giving up their cultural practices.

Our Solution

Our solution is “Call Aunty”! This is a two part program that targets both the community health worker (CHW) as well as the pregnant women (let’s call her Aisha) living in rural Bangladesh. The Call Aunty process starts with a call from Aisha, initially with the help of her CHW during their first appointment. At this point Aisha meets Aunty who asks her a few personal and health related questions to register her into the Call Aunty service. At the end of this call Aunty automatically determines Aisha’s risk level, her estimated due date and gives a brief, tailored recommendation based on the information given. The CHW sees the results of Aisha’s answers on her app as well as the recommendation given by Aunty. Based on Aisha’s risk level, Call Aunty schedules automated check-in calls to get updates on any symptoms and revise Aisha’s risk level and recommendations throughout her pregnancy. Our goal is to reduce the number of CHW visits needed for low-risk women so that these workers can focus on higher-risk women.

Future Development

In the future we hope to scale Call Aunty by: Creating extensive diagnostic questions and recommendations Creating an SMS feature to alert CHWs of appointments and nudge women to follow-through on recommendations Develop a scheduler for CHW to manage appointments Support pre-pregnancy and postnatal (up to a year) Develop a partnership with the government so that they have access to the Call Aunty database in order to make better healthcare resourcing decisions

The Experience

Aisha (persona of pregnant women) Aisha is a 16 year old married pregnant women living in rural Bangladesh. She is Muslim, only speaks Bengali and has limited education. Aisha’s goals are to have a healthy pregnancy all while fulfilling her duties within her society. She currently understands the traditional methods of dealing with a pregnancy from her elders but sees the women in her life passing away from the lack of healthcare resources and information.

Benefits to pregnant women: Aisha is able to get the best recommendations on a regular basis only only through visits from her CHW but also by simply getting in touch with Aunty Aisha is able to avoid leaving her comfort zone by engaging in a “conversation” with her new and informed Aunty, just like she would in her regular day-to-day life Aisha is empowered with tailored health information to manage her pregnancy and care for her baby

Zainab (persona of Community Health Worker) Zainab is a 38 year old woman in rural Bangladesh with basic level of education. She has access to both a smartphone and tablet and uses it during her 800-1000 appointments per month. She has limited training, doesn’t speak english and works very long hours each day. Zainab is typically worried about getting to all ~45 of her appointments per day and therefore does not have enough time to prepare for each. During her appointments she is focused on updating Aisha’s profile with notes and recommendations and therefore needs quick access to her records. Zainab’s ultimate goal is to help her patients survive their pregnancies and early childhood.

Benefits to Zainab: Zainab is able to identify high risk pregnancies instantaneously Zainab has easy access to her patients’ records, risk factors and appointments Zainab is now able to prioritize high risk pregnancies and make them her greatest focus Zainab is able to do her job more efficiently Aunty takes some of the logistical requirements of Zainab’s job off her hands and make her job more efficient (ex. Aunty sends automated reminders for appointments and tracks the patient's’ birth plan and due date)

Promotional Strategies

Positioning Statement Call Aunty is a free, high quality support system for pregnant women living in rural Bangladesh, that provides them with information and resources to help them actively plan for their pregnancies, in a comfortable and culturally acceptable setting

Slogan “Have you called Aunty Yet?”

Target Market

Pregnant women living in rural Bangladesh Ages: 16-35 Education: Limited Religion: Muslim Marital Status: Married Language: Bengali only Access to Phone: Yes (SMS) Lifestyle: Very social and relies heavily on elders’ recommendations and guidance

1. Referral Program (generate awareness) Use influential and credible pregnant women within the rural communities to promote Call Aunty Incentive such as no wait time during their next clinical visit is provided to these women when they refer and successfully secure a new user Why: This strategy was chosen because rural Bangladesh is very collective and social. Therefore, successful early adoption relies heavily on word-of-mouth generated by the influential women in the community

2. Partnership (reminder advertisement) Partner with popular brand in rural Bangladesh (ex. A beauty brand) to incorporate Call Aunty’s phone number, logo and slogan to their packaging Why: This will make Call Aunty’s information more readily available and will prompt the pregnant women to call right away.

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