Replicating A Successful Digital Health Innovation
Strengthening National Family Planning Helpline for Follow-up Counselling
Improving the use of modern contraceptives has significant potential to reduce unintended pregnancy and increase inter-pregnancy intervals, which lead to poor health consequences for mothers and infants. High-quality family planning (FP) counselling is pivotal for making that potential a reality, but it is a challenge to provide comprehensive FP counselling in overcrowded health facilities.
Another stumbling block: the inaccessibility, when women start experiencing side contraceptive effects, of needed counselling that would encourage them to continue with the method.
The insight obtained from Abt’s private-sector FP work in India led us to design an innovative digital solution in 2011 for women using the DMPA (Depot-medroxyprogesterone Acetate) contraceptive. Trained counsellors used mobile phones at regular intervals to contact women in their homes. The private-sector solution, known as Careline, enabled counsellors to discuss contraceptive side effects with more than 35,000 women when they needed it most. And it had the desired effect: a high continuation rate for the method the women chose for themselves.
Careline’s success facilitated its replication as Antara Careline in the public sector in five Indian states from 2017 to 2021. Antara Careline conducted more than 360,000 counselling sessions and transitioned to state governments, which now run the program.
The Ministry of Health & Family Welfare (MoHFW) recognized the Antara Careline’s success and Abt’s rich experience managing follow-up tele-counselling on FP. So the Government of India asked Abt in October 2021 to provide technical support to strengthen a similar helpline set up by the MoHFW. The helpline, known as National Family Planning Helpline (NFPHL), was functioning at a limited scale, receiving inbound calls from users or potential clients for information on contraceptives. The success of the Antara Careline helped MoHFW visualize the far-reaching benefits of upgrading it to a center providing follow-up counselling and helping women continue with the method they chose.
Abt is supporting the Family Planning Division, MOHFW, in its efforts to strengthen the national family planning helpline to ensure provision of follow-up counselling to women through inbound and outbound calls. Abt developed standard operating procedures, training manuals, and scripts to align with the newly developed call algorithms for inbound and outbound calls. The goal is to reach critical target groups such as newlyweds, young low parity couples, postpartum, and post-abortal woman. The helpline will also give follow up counselling support to users of DMPA and intrauterine contraceptive devices to help them continue with the method of their choice.
Abt conducted two rounds of training of helpline counsellors to build their capacity to impart quality follow-up counselling services. Abt is also working with MoHFW to facilitate architectural changes in IT systems, workflows, digital alerts, call prioritization protocols, data entry elements, including revisions in IVRS scripts, and customer relationship management.
To sustain program momentum, Abt designed a complete training package for helpline counsellors with modules on:
- Knowledge building, comprising technical aspects of FP and various contraceptives
- Skill building, demonstrating best practices of counselling.
The Ministry of Health will use this package as an induction training for new counsellors and a refresher training for existing counsellors. The national helpline, which integrated learnings from the Abt-developed Antara Careline, is a model for other digital health solutions and a significant milestone for women and couples in India seeking high quality family planning.
