SMS for prenatal care

I ended up making a pros and cons list for SMS-based services, because I often felt that a) it was being used when it didn’t need to be used and b) many of the services I envisioned had already been implemented. Many of the “cons” had to do with the major limits we have with SMS — character length and GPS info, mostly. However, there were two major “pros” that fascinated me.

The obvious one: A large majority of people in places like Uganda have access to SMS.

Secondly, once users send you a text, you have their information. So you can ping them whenever you want, as long as they don’t unsubscribe. For my idea, this is key.

I created a SMS service that helps pregnant women in Uganda. (An aside: I’m in Design for UNICEF, where we’re focusing on Uganda — so that’s been on my mind. Thus far, though, we are brainstorming ideas not related to SMS.) Prenatal care is vital in Uganda, but many women don’t see a doctor during pregnancy. But if they are subscribed to an SMS service, that service can remind them the importance of seeing a doctor. It can also help them answer questions and find the closest doctor.

Here’s how the test service works:

1. INITIAL TEXT: When a woman finds out she is pregnant, she texts “PREGO” to 41411.

2. INFO GATHERING She gets a response: “Congratulations! How many weeks have you been pregnant? Reply by typing ‘PREGO’ followed by the number of weeks. For example, ‘PREGO 28′”

3. DIRECTED RESPONSE: Depending on how far along she is, the service gives her a specific message. Right now, it’s fairly simple. But I think this can be built out pretty extensively.

3a. REAL-WORLD REFERRAL: Some of the messages direct her to a doctor, and the idea is that there is a service built in that tells her where the nearest one is.

4. REMINDERS: This part hasn’t been implemented but: Since we know how far along she approximately is, the service can send her a text message every week, reminding her to see a doctor or giving her hints on what she should be doing at that stage in her pregnancy.

The idea is that this would be a free service — or at least highly subsidized — so the individual doesn’t have to pay SMS charges.

This builds off a UNICEF initiative that tries to get children birth certificates via SMS, which has been fairly successful. (link)

On a technical note: I used TextMarks (with a PHP script) to create the service. It was incredibly easy to create, which makes me pretty¬†excited. Here’s the script below:

<html>
<body>

<?php

$from = $_REQUEST['from'];
$message = $_REQUEST['msg'];
$weeks = 10-$message;

if ($message == "") 
	echo "Congratulations! How many weeks have you been pregnant? Reply by typing 'PREGO' followed by the number of weeks. For example, 'PREGO 28'";
else if ($message == "doctor")
	echo "Here are a few doctor: Mr. Doctor, 11 Doctor Drive; John Doc, 14 Medical Street";
else if ($message == "yes")
	echo "Congratulations! You should get your baby registered by texting TKTKTKT. This will help your child get medical care.";
else if ($message == "help")
	echo "COMING SOON...";
else if ($message > 10 && $message < 36 ) 
	echo "Have you seen a doctor? If not, this is very important. If you need help finding one, reply with 'PREGO DOCTOR'";
else if ($message < 10) 
	echo "In {$weeks} weeks, you should see a doctor. If you need help finding one, reply with 'PREGO DOCTOR.' For other tips, reply 'PREGO HELP'";
else if ($message > 36  && $message < 40 ) 
	echo "You're going to give birth soon! If you need help finding athe closest doctor, reply with 'PREGO DOCTOR'";
else if ($message > 40 ) 
	echo "Have you given birth yet? If yes, reply with 'PREGO YES'. If not, see a doctor; reply with 'PREGO DOCTOR' to find the nearest one.";
else echo "We don't recognize your answer. Try again.";
?>

</body>
</html>

This is a human-to-computer interaction that I think works for three reasons: a) It doesn’t require massive manpower, b) a database can keep track of the information a women gives the program and c) it gives the teeny bit of anonymity, which might be crucial for women who have unwanted pregnancies.

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