One to One in the Presence of Many

Posted on: October 11th, 2013 by Thea

Making Authoritative Health Information Accessible
By Rohini Bhatia

“Where is the best place for dessert in Ocean City?” My brother looked around quizzically for a reply, and when we responded in shrugs and blank stares, we all pulled out our cell phones – texting and Google-searching for the right answer.

Tools such as cell phones empower individuals to find anything from libraries and restaurants to the closest hospitals and family planning clinics. Yet in areas without external 3G towers, where cell phones may be prominent, but a lack of data plans and wi-fi exist, what is a quick and reliable method for sharing information? In particular, how can organizations and governments promote healthy behaviors and share reliable information in these environments?

“The key is to provide nonjudgmental, accurate information in a confidential way,” said Ms. Uju Ofomata, Program Director for Mobile4Good at One World UK. Learning about Living in Nigeria, one such initiative, focuses on e-learning, social media, and radio use as a medium for sexual and reproductive health information dissemination. In areas where mere mention of sex or condoms can cause scandal, how do the youth grapple with issues and questions of sexual and reproductive health (SRH) to learn fact from fiction?

Their idea is both simple and revolutionary. OneWorld started the program on the invitation of the MacArthur Foundation who had heard about their innovative work using mobile phones. The idea was to use similar technology to support grantees in Nigeria with projects on SRH and maternal health education. Data from Nigeria called for a revolution in sexual and reproductive health education. In 2006, the average age of first sexual activity among girls was 13 and 60% of new HIV infections were in the 15-25 age group.

They began by asking the adolescent population what they would want from such a program. The overwhelming response derived two main themes: anonymity, and the truth. Talking about sexual health and reproduction at a young age is difficult; however, talking about it in a society such as Nigeria where expert information is hard to reach, where cultural myths can cloud an understanding of the issues, and where taboos and stigma of sex and HIV are prevalent, raises further challenges.

Radio and text messaging prove to be valuable tools for educating the youth population because they are both prevalent and inconspicuous.  First, radio programming assists in achieving anonymity. Often, phone use is restricted to individual social and mobile networks. This is magnified in countries in Africa. Youth won’t text about plans with friends if they are in the presence of someone who might see; furthermore, that text can be documented evidence of a relationship that should or should not exist. This is where radio programming comes in. Touted as a “1 to 1 in the presence of many” conversation, the radio puts personal questions on air where the youth can listen through their mobile phones.

The Question and Answer service provided is through a 3 in 1 service of text messaging, calling in, and the project website. Trained counselors respond to queries either through searching a stored FAQ database or through consultation with an external medical doctor. Questions that have been texted include “does the HIV virus live in the saliva fluid?” or “Please, where can I get tested for HIV/AIDS?”

Peer education has been a driving force in the success of this program as well. OneWorld estimates that about 60% of users of this program share the knowledge they receive with their friends. Through this, the program builds a network of individuals more empowered and knowledgeable on issues ranging from HIV prevention to family planning. The program has had more than 900,000 text messages since its inception and has reached an approximated 500,000 students and upwards of a million radio listeners. This use of technology could further be used for a range of health messages, including prevention of non-communicable diseases. Habits like healthy eating, quitting smoking, and daily physical activity can be inculcated through accessible and anonymous reminders and tips to the masses.

It is a valuable lesson to keep in mind: utilizing the existing infrastructure of technology within a country to promote access to knowledge lends itself to amazing achievements. From radio programs about STD testing to anonymous question and answer texting programs, we can revolutionize the delivery of accurate information and knowledge.


Rohini Bhatia is a recent graduate of the University of Rochester in Epidemiology and is spending a year in India researching

women’s tobacco use in India.