Developing Personalised Health Calendars: Re-cal-l
Re-cal-l is for the 2.6 million women and children at risk of dying every year because they do not get the antenatal, delivery and postnatal care and immunisation services they need.
Re-cal-l is a personalised health appointment reminder system for women and children in remote rural areas.
Rahmat’s story
Rahmat received her personalised calendar from her local community health worker, putting her at ease. She says, “What I liked about the calendar is that it reminded me of all the visits during the pregnancy and after delivery.”
Thanks to the calendar, Rahmat was able to keep track of all her appointments during pregnancy and after birth; “the calendar reminds me of the dates of the visits, and I then go to the health facility to get the services.”
Rahmat gave birth to a happy, healthy baby girl and is still making use of her calendar. “I am using it as a reminder of my child’s vaccination dates. I have already taken my child for her first vaccination at the health facility. I am looking forward to using it for the remaining vaccination dates.”
The calendar and ongoing support from her health worker will ensure Rahmat and her baby will stay safe and well.
Re-cal-l in Goro Woreda, Ethiopia
The problem
Despite impressive improvements, too many women and their children still die from preventable and treatable conditions. Existing, simple solutions can provide a solid foundation to improve mother and child health and survival.
Attendance at antenatal care, delivery with a skilled birth attendant, attendance at postnatal care, and uptake of immunisation could save over 2.6 million lives every year.
Unfortunately, coverage of these solutions is still far from universal, particularly in poor countries with the highest rates of mortality. Here behavioural nudges can increase timely and complete uptake of these solutions.
Mobile technology provides an important platform for these nudges, but will not reach those who do not have access to a mobile phone – more than 1.7 billion of the world’s poorest women.
Analogue reminder systems are also needed. Experience shows that these work best when they are personalised, locally designed and combined with home visits by health workers.
An innovative solution
Re-cal-l is a simple, analogue, personalised health appointment reminder system for women and children in poor countries, particularly in areas with low mobile phone usage.
In the Re-cal-l system community health workers receive basic training to identify pregnant women in their catchment areas and visit them at home to tailor personalised wall calendars, using a paper-based ‘contact calculator’ to ensure accuracy.
The calendars display all their recommended health and immunisation appointments before, during and after birth in a comprehensive and accessible way – supporting timely and complete uptake of these services.
Community health workers also use dates from the calendars to plan their routine home visits, ensuring they are there to provide support and advice when they are most needed.
At scale, the full Re-cal-l system could cost as little as $3.75 to reach and support a mother/child pair.
What we are doing now
Women and Children First is continuing to incubate the Re-cal-l innovation.
Re-cal-l has been subjected to several rounds of extensive prototyping by our team with advice from world leaders in mother and child health. Initial cost models have also been built and refined.
It is now undergoing rigorous pilot testing in Ethiopia. We have consulted, collaborated and co-created on a small scale with pregnant women and community health workers to refine Re-cal-l further and make sure it is responding to their needs.
Our next step will be to refine and test the business model to successfully bring it to scale - one route with significant potential is via sale of advertising space.
Following this, we will be able to scale up Re-cal-l - supporting widespread adoption across developing countries. Conducting this in a phased manner will allow us to validate its effectiveness on maternal and child health and mortality at large scale.
Why Re-cal-l?
1) Re-cal-l can increase attendance at antenatal care, delivery with a skilled birth attendant, attendance at postnatal care, and uptake of immunisation. If these interventions reach 90% coverage, 2.6 million lives could be saved every year.
2) Re-cal-l can reach the poorest and most marginalised.
3) Re-cal-l can cost as little as $3.75 per mother/child pair.
4) Re-cal-l calendars provide an attractive last-mile advertising opportunity.
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