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Asha Rani, a satisfied user of Aponjon mobile health service
Asha Rani, a satisfied user of Aponjon mobile health service
“Well…to tell you the truth, now I know that I should keep my daughter on my shoulder for a few minutes after she receives breast milk. She doesn’t vomit anymore and I am so relieved. The Aponjon service helped me to get accurate health messages on how to raise a child as well as to take care of my own health.”

Asha Rani, a 24-year old woman happily married with two children, lives in the Vashantek slum in Mirpur, one of the most crowded slums in Dhaka city. She lives with her husband, children, and in-laws in the same compound which is a practice in Bangladeshi family norms. Asha’s family is very loving and respectful, but when she started to raise her first child, she realized she did not know important things about how to raise a healthy child. For example, she had questions about immunization needs, nutritional diet, and common physical ailments that can be managed at house hold level.

After the birth of her second child (a daughter named Debi), a health worker informed her about ‘Aponjon’, a new service that provides the type of health information she was looking for. She found out that, Aponjon is a mobile health service that provides health related information to expecting and new mothers, and also their gate-keepers e.g. husbands, parents and parent-in-laws. This service provides pre-programed voicemail and text messages on health and safe motherhood to encourage the adoption of best practices during pregnancy and delivery. After getting acquainted with Aponjon, Asha is now an excited registered user of the service.

New information that Asha learned from the service

After registering with the ‘Aponjon’ service, Asha is now well informed about the immunization schedule for her daughter, and got motivated to take her to the health facility for vaccination. The ‘Aponjon’ service has made her knowledgeable on supplementary food choices for her child after her daughter had 6 months of exclusive breast feeding. Now, even her mother-law is unable influence her to feed her baby cow milk.

Asha, particularly likes the Aponjon message where, mothers are advised to make direct eye contact while interacting with the baby. Accordingly, Asha maintains eye contacts while talking to her baby. She believes it is helpful in developing bond between her baby and the mother. She also talks with her baby with a clear accent so that the baby learns to speak in a clear accent she grows up.

Changes in the family and community

Asha and her husband share the same phone. Every week her husband receives SMS text messages on his mobile phone - two for his wife and one for himself. When he returns home at night, he reads the messages to Asha from his mobile phone. Ash’s husband is now much knowledgeable about their baby’s health. He is now more aware about the child’s nutrition, immunization schedule and actively learns from the messages.

Asha is a very satisfied user of Aponjon. She not only uses it, but she also encourages others in her community to register to this service and she feels it is her responsibility to inform others about this helpful service.

Aponjon is created under the umbrella of Mobile Alliance for Maternal Action (MAMA). In Bangladesh, it is implemented and coordinated by D.Net. MAMA is just one activity that the U.S. Government, through USAID, has supported. In total, USAID has provided more than $5.8 billion in development assistance since Bangladesh’s independence, including over $770 million invested in health outcomes. As part of President Obama’s Global Health Initiative, USAID in 2011 provided more than $61 million to support health programs in Bangladesh in the areas of maternal and child health, voluntary family planning, nutrition, and to combat tuberculosis and HIV/AIDS. USAID currently dedicates about $180 million every year to improve the lives of people in Bangladesh; promote democratic institutions and practices; expand economic opportunity; improve health and education services; increase food security and support Bangladeshi efforts to mitigate the impact of natural disasters.
‘Aponjon’ is like a caring family member to Nasima
‘Aponjon’ is like a caring family member to Nasima
“I find all the information of ‘Aponjon’ very useful as they talk about my own good”, says Nasima Khatun, a 27-year old housewife living with her husband and two sons in a crowded slum of Vashantek, Mirpur in Dhaka city.
Her husband, who works at a factory in gazipur, is the only income source of the family. Their household expenditure is about BDT 10,000 (USD 120) per month.

Nasima came to know about the ‘Aponjon’ service from a Shashtho Kormi (health worker) who visits her and gives her consultation for postnatal and child care. The Aponjon service is created under the umbrella of Moblie Alliance for Maternal Action (MAMA)/Bangladesh initiative, which is funded by the United States Agency for International Development (USAID), US Government’s premier development agency and also supported by private donors such as and Johnson and Johnson. Under the ‘Aponjon’ program, expecting and new mothers, husbands and mothers-in-law will receive pre-programed voicemail and text messages on health and safe motherhood to encourage the adoption of best practices to ensure safe pregnancy and delivery.

To effectively reach the mothers in the rural level, MAMA has partnered with local development NGOs like BRAC, MCHIP (MaMoni Program), Smiling Sun Franchise Program (SSFP), Social Marketing Company (SMC) and Fair Price International (InfoLady).

Nasima first got to know about Aponjon when a BRAC health worker told her about this new service. After registering with Aponjon, she can now listen to important health messages twice a week through her mobile phone. She can also retrieve old messages by simply dialing 16227 or dialing 16227 and 1 which takes her to the call center helpline.

‘Aponjon’ is like a caring family member

Aponjon service taught her a lot of things. She has learned to eat nutritious food during pregnancy and to keep her baby clean and wrapped with soft clothes. ‘Aponjon’ empowered her and gave her confidence to raise her second child all by herself as she doesn’t live with her in-laws; the messages she is receiving are giving her invaluable and timely information, which her mother or mother-in-law would have given her. Now she does not have to visit the health clinics for every single basic question.

The power of health in her hand

When asked why she likes ‘Aponjon’ service, Nasima told that she was very young when she gave birth to her first baby, who is now 12 years old. “Aponjon is providing me with important health information which I did not know when I had my first baby 12 years ago. The messages are particularly helpful when I have no one else beside me to take care of my newborn. I am willing to pay more for this service if it gives me important and useful messages”, says a confident and satisfied Nasima. Even though her husband is not registered with the gate-keeper’s Aponjon service, he is happy that his wife is getting access to necessary health information.
Shumi Dev takes Aponjon forward in the community
Aponjon is an inspiration for both Health Workers and clients
Shumi Dev is a 24 year old community health worker (CHW) who has been working for MAMONI in Balaganj (Sylhet) under the supervision of SHIMANTIK. Her primary work is to disseminate information about antenatal checkup, postnatal check, safe delivery and family planning methods among expectant women, new mothers and eligible couples. She had received training from “Aponjon” team along with her 13 colleagues in her area during the pilot phase. For “Aponjon” she registers expectant women and new mothers who have mobile phones in their houses and who want to receive weekly messages throughout pregnancy and until the first birthday of their child. Shumi approaches the poorest of the poor who do not have access to doctor and who needs behavioral orientation to improve maternal and child care at household levels. She identifies women who have a mobile phone handset at home, who are eligible to receive the service (expectant women/ have child less than 1 year of age), explains the service mode and take consent to register them for the service. She uses a registration form of “Aponjon” and captures socioeconomic condition of each client for further socio-demographic considerations. She thinks that “Aponjon” is reaching out to women and family who needs critical health information badly.

“I think the service will be very good for people who happen to come from low-income group. Wealthy and middle income people who consult doctor on regular basis and are exposed to a lot of health information may not think the service is required for them. I am already getting a lot of response from the low-income group.” says Shumi Dev.

Shumi has been with “Aponjon” since the inception of the pilot phase in 2011. She is one of the health workers of the pilot whose feedback in the service on pricing policy, call center, registration process and customer acquisition process was incorporated in the service before roll out.

Shumi thinks the service is creating awareness among people about the things they should do to avoid any mishaps. For example, women and families are reminded about their appointments with their doctors for antenatal and postnatal checkups which they are following. Women and families have faith the mobile messages provided by an expert doctor, so when the “doctor” in the messages is asking them to test their blood groups they are immediately testing their blood. Shumi thinks “Aponjon” is making her life easy by motivating people to take action accordingly without having fear.

“‘Aponjon’ tell women about danger signs or symptoms and not to panic. Women listen to the mobile messages, realize what they are going through is a normal process and gradually perform the works that we (also) have been asking them to do.” The inspired Health Worker feels proud to be able to transfer her inspiration to the community in so dire need of trustworthy effective information.