Research and reality

Rural health workers in India do not always have the training, credibility or motivation to effectively convince clients to adopt healthy practices. To help build their efficacy, we provided them with messages on mobile phones to present to clients. We present a study which compared three presentations of persuasive health messages by health workers using a phone-based lecture-style message, a phone-based dialogic message that elicits user responses, or no additional aids. We found that dialogic messages significantly improve the quality of counseling sessions and increase discussion between health workers and clients; however, we did not statistically measure an effect of either phone-based message on health behavioral outcomes. We analyze these results in light of the challenges we faced and compromises we made through the research process due to the interplay of social, cultural and environmental realities, and discuss how these factors affect ICTD projects at large.