Uptake and impacts of mobile apps for improving state effectiveness

This project will evaluate the impact of a maternal and child health mobile application in Myanmar, as a potential intervention to overcome gaps in state capacity to distribute health knowledge. The ‘MayMay’ app has been developed by Koe Koe Tech, a local firm specialising in the IT and health sector, in collaboration with Population Services International, a global non-profit organisation operating in Myanmar and over sixty developing countries. The ‘MayMay’ app targets pregnant women and mothers of young children, and sends text messages containing health information tailored to the stage of pregnancy and child’s age. Each text message is based on information approved by Myanmar’s Ministry of Health

Myanmar currently suffers from poor healthcare delivery, and pregnancy-related deaths are one of the leading causes of mortality among women of reproductive age in Myanmar. However, expanding health care infrastructure to cities and remote regions would constitute an overwhelmingly resource- and time-intensive effort in Myanmar, where there are currently only 4 doctors per 10,000 citizens. In the short term, given the recent expansion of mobile coverage, mobile health technologies represent an ideal potential solution for expanding service delivery and improving healthcare outcomes. Mobile phones allow health information to be delivered to an unprecedented majority of the population that would otherwise remain under-served. Mobile phones are therefore a powerful instrument for providing healthcare information in rural and urban areas of Myanmar. This is critical in light of growing evidence about the critical impact of early-life developmental inputs on long-run socio-economic outcomes.

Little is currently known about how to most effectively utilise mobile technology to provide health information in a developing country context. This project will investigate how to most effectively convey information and encourage behavioural change (such as encouraging users to visit formal doctors rather than traditional doctors). This project will used a randomised trial to evaluate the take-up of the ‘MayMay’ app and its impact on the health knowledge and health behaviour of pregnant female users, as well as the spill-over effects of the app for friends and relatives of users. This will build on broader economics literature on the take-up of new technology, and the diffusion of technology through social ties and networks, which has the potential to yield social multiplier effects of the primary intervention.

The scope of this project goes beyond the Myanmar context. There is currently little evidence on whether mobile technology can cost effectively communicate health information to the population, and this project will help expand this body of knowledge. Myanmar presents an ideal environment for studying this question, due to the historical lack of mobile technology and alternative sources of health information. More broadly, the pregnancy monitoring app addresses two of the Millennium Development Goals of reducing child mortality and improving maternal health.