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  • Using Interactive Voice Response for SBC

Using Interactive Voice Response for SBC

Interactive voice response (IVR) is an automated, phone-based platform that can be used in social and behavior change (SBC) programs to provide individuals with information, pose questions and record user responses, and remind users of upcoming appointments or the need to take medication. After listening to recorded prompts, the user touches a phone keypad to capture their responses. IVR systems can provide pre-recorded or dynamically generated audio to further direct users. IVR also allows users to interact with the host's system by recording a question. 

IVR platform structure can range from a single prompt to multiple navigation options. The degree of interaction can also vary significantly between platforms, from one-way information provision to true dialogue.

IVR technologies are not as common in low- and middle-income countries; however, public health programs are increasingly using IVR to reach populations with high penetration of mobile phone ownership but with low levels of literacy and internet use. IVR offers an alternative to sending text messages, which is especially relevant given the increasing numbers of registrants on “Do Not Disturb” lists, perhaps evidence of user fatigue with the SMS system. Research indicates that organizations today cannot even pay people to receive SMS. Viamo found that using IVR instead of text messages in Ghana resulted in participation rates two times higher for women, four times higher for rural populations, and ten times higher overall.

Potential benefits of using IVR:

  • Accessible regardless of type of phone, carrier, or internet connection
  • Can serve audiences who speak different languages
  • Capable of overcoming literacy concerns due to its auditory and oral nature
  • Good for users who are comfortable using their phone
  • Users don't get "spammed" with many "calls" like with SMS
  • Provides the possibility of collecting large quantities of qualitative and quantitative data for very little cost by asking questions of mobile phone users rather than having to interview respondents face-to-face
  • Offers benefits beyond SMS data as it can also collect voice data

Potential disadvantages of using IVR:

  • Can be more expensive than SMS since it involves an actual phone call
  • Users not familiar with this format may be uncomfortable using it
  • An SMS can easily be ignored, but answering and responding to a phone call involves time 
  • Possibility of dropped calls
  • Expenses and time involved in data cleaning once responses are collected, and this usually involves hiring an outside firm

In this Trending Topic, the Compass offers several tools and sample project materials on IVR. We invite you to add your own materials: upload a new material, read the contribution criteria, or write to info@thecompassforsbc.org.

Peer-Reviewed Publications

  • Tripathi, V., Arnoff, E., & Sripad, P. (2019). Removing barriers to fistula care: Applying appreciative inquiry to improve access to screening and treatment in Nigeria and Uganda. Health Care for Women International, 1-16.
  • Vota, W. (2019). Is the era of SMS dead? Long live interactive voice response! ICT Works.
  • L'Engle, K., Sefa, E., Adimazoya, E.A., Yartey, E., Lenzi, R., Tarpo, C., Heward-Mills, N.L., …Ampeh, Y. (2018). Survey research with a random digit dial national mobile phone sample in Ghana: Methods and sample quality. PLOS One, 13(1), 1-11.
  • Tsoli, S., Sutton, S, & Kassavou, A. (2017).  Interactive voice response interventions targeting behaviour change: a systematic literature review with meta-analysis and meta-regression. BMJ Open, 8, 1-14.  
  • FHI 360. (2020). Can mobile phone surveys replace house-to-house data collection? Using interactive voice recognition to assess media exposure and behaviors. [Durham, NC: Author]. 
  • Daftary, A., Hirsch-Moverman, Y., Kassie, G.M., Melaku, Z., Gadisa, T., Saito, S. & Howard, A.A. (2016). A qualitative evaluation of the acceptability of an interactive voice response system to enhance adherence to isoniazid preventive therapy among people living with HIV in Ethiopia. AIDS and Behavior, 21(11), 3057-3067.
  • Swendeman, D., Jana, S., Ray P., Mindry, D., Das, M., & Bhakta, B. (2015). Development and pilot testing of daily Interactive Voice Response (IVR) calls to support antiretroviral adherence in India: A mixed-methods pilot study. AIDS and Behavior,19(Suppl 2), 142-155.

Footnote: (1) According to data from the International Telecommunication Union, an organization within the United Nations, the penetration of mobile line subscriptions reached 98.7% of the population in developing countries in 2017. The World Bank estimates that, in countries with low- or medium-level economies, there are more people with access to mobile devices than to water or electricity.

Banner photo: © 2012 Kuntal Kumar Roy, Courtesy of Photoshare

Resources

  • Tools
  • Examples

The mHealth Planning Guide: Key Considerations for Integrating Mobile Technology into Health Programs

The Guide helps individuals and organizations appropriately plan for mHealth deployments. The Guide:

View Resource

Creating Mobile Health Solutions for Behaviour Change: A Study of Eight Services in the mNutrition Initiative Portfolio

This report presents key findings from the implementation of the GSMA mNutrition Initiative, including service design lessons, and presents nutrition behavior change outcomes achieved throughout the program. This implementation took place in eight countries: Malawi, Ghana, Tanzania, Kenya, Nigeria, Zambia, Uganda, and Mozambique.

View Resource

Why is IVR Important?

This guide is aimed at businesses which use IVR for sales, but can easily be adapted and used for social and behavior change projects. It provides an overview of how interactive voice response (IVR) works, why it is used, and its advantages and disadvantages.

Included is information about:

View Resource

Rapid Pro Essentials Online Course

This one-hour interactive on-demand online course developed by UNICEF and TechChange teaches participants how to get started with RapidPro, a new open source software that allows you to easily build and scale mobile-based applications and services from an

View Resource

mHealth Mobile Messaging Toolkit: Considerations When Selecting a Mobile Messaging Platform Vendor

This toolkit provides information about currently available mobile messaging technology solutions, as well as things to consider when selecting a vendor and deploying a mobile health, or mHealth, campaign. It is meant to be used with other resources on project design, content development, and behavioral change communications, including Planning an Information Systems Project: A Toolkit for Public Health Managers.

View Resource

Interactive Voice Response and Radio for Peacebuilding: A Macro View of the Literature and Experiences from the Field

This report provides a broad overview and assessment of how interactive voice response (IVR) systems are being implemented in international development work with an emphasis on the particular role IVR can play in peacebuilding work in post-conflict contexts. In order to narrow the scope of research, this study focuses primarily on the usage of IVR in conjunction with radio for development projects in different crisis and post-crisis zones in Africa and India, as operationalized within the larger international development contexts. 

View Resource

Messages for Interactive Voice Response, Nigeria

Nigeria

Breakthrough ACTION-Nigeria managers sent reminder messages to people who received referrals for health services (e.g., antenatal care, immunization, malaria testing). 

Download

Evaluation of the Effects of Smart Couple Digital Health Tool in Kaduna, Nigeria

Nigeria

This report presents findings from a quasi-experimental pre-post design trial designed to assess the effects of a digital health tool among couples of reproductive age in Kaduna City, Nigeria. Study participants included 670 women and 652 men who listened to an entertainment-education series on their mobile phones and then participated in the post-study survey. 

Download

Smart Client and Smart Couple: Digital Health Tools to Empower Women and Couples for Family Planning

Nigeria

To prepare women and men for more effective FP decision-making communication before, during and after a counseling visit, under its global activities, the Health Communication Capacity Collaborative (HC3), a project under the Johns Hopkins Center for Communication Programs (CCP)  developed two “smart client” tools – one prioritizing women, and o

Use of an Interactive Voice Response System to Deliver Refresher Training in Senegal: Findings from Pilot Implementation and Assessment

Senegal

The USAD-funded CapacityPlus project, led by IntraHealth International, developed, deployed, and assessed an innovative mLearning system that used a combination of IVR and SMS text messaging to deliver refresher training to family planning providers in Senegal, focusing on management of contraceptive side effects and counseling to dispel misconceptions. 

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Project m-Maitri: Interactive Voice Response (IVR) for Parent-to-Child Transmission

India

In 2016, Solidarity and Action Against the HIV Infection in India began a partnership with Janssen Global Public Health, an initiative of the Janssen Pharmaceutical Companies of Johnson & Johnson. The initiative, named m-Maitri, aimed to complement on-the-ground efforts at ensuring retention in the prevention of parent-to-child transmission cascade with interactive voice response (IVR) to consenting pregnant women and mother-baby pairs until the babies reach 18 months of age.

View Resource

The Use of IVR to Support Monitoring and Evaluation of Media Interventions: A Case Study of the VOTO System in Rwanda

Rwanda
In this report the authors explore the potential that IVR systems have as both a distribution and an M&E tool, noting the limitations the current state of IVR technology imposes. 
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View Resource

How Digital Health Platforms Connect Women to Maternal Health Services

Nigeria
Uganda

In 2017, Fistula Care Plus (FC+) partnered with Viamo to provide a free phone hotline that screens women for fistula in Nigeria and Uganda. This blog describes how the program was designed and implemented.

View Resource

Can Mobile Phone Surveys Replace House-To-House Data Collection?

Ghana

This brief describes an effort to use interactive voice recognition to assess media exposure and behaviors in Ghana.

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This website is made possible by the support of the American People through the United States Agency for International Development (USAID) under the Breakthrough-ACTION Project, supported by USAID’s Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreement #AID-OAA-A-17-00017 with the Johns Hopkins University.

Breakthrough-ACTION is based at the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs (JHU∙CCP). The contents of this website are the sole responsibility of JHU∙CCP. The information provided on this website is not official U.S. Government information and does not necessarily represent the views or positions of USAID, the United States Government, or The Johns Hopkins University.

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