DEVELOPMENT OF AN M-HEALTH INTERVENTION FOR THE INFANT AND YOUNG CHILD FEEDING COUNSELLING IN THE PLANTATION SECTOR OF SRI LANKA

Background and objectives: Sri Lankan health indicators are relatively better when compared to similar socio-economic countries. But the progress on child under-nutrition is poor, which is prominent in plantation sector. M-health is a possible technology to deliver feeding counselling, with relatively lower costs in these settings by improving access, quality, and timeliness. The aim of this study was to develop an M-health intervention suitable for the plantation sector of Sri Lanka for infant and young child feeding counselling. Methods: The research team conducted a formative study in the plantation sector to assess the acceptability of an intervention using mobile phones, registration of the clients, mode (text or voice) and timing of messages and signal strength. This lead to the development of an intervention with four stages. Results: Stage I Age appropriate sequence of text and voice messages were developed, aiming pregnant mothers with gestational age over 28 weeks and mothers of infants up to 2 years of age. Messages focused on encouraging mothers on exclusive breastfeeding, appropriate complementary feeding, relevant hygienic practices, immunization and micronutrient supplementation. Text messages were in Tamil text and voice messages were in female Tamil voice. Both were interactive messages and at the end of each massage the receiver was asked whether there are any feeding issues and the urgency of the issue. All the issues were notified to Public Health Midwife (PHM) through another text message. Stage II A mobile platform was developed to send the above messages to registered clients in partnership with a professional mobile service provider in Sri Lanka - Dialog Axiata PLC Messages sent on fixed dates and times during the week. Stage III Mobile application was developed for the use of the PHM, with the same mobile service provider for the registration of the clients. The application worked online and offline and was able to operate through smart phones or computers. Stage IV Clients and PHM were trained on use of mobile phones. Conclusions: An M-health intervention was developed for infant and young child feeding counselling for the plantation sector of Sri Lanka which needs to be pilot tested.