Half the Sky: Exploring the Use of Mobile Phone Games to Address Reproductive Health

1. Half the Sky: Exploring the Use of Mobile Phone Games to Address Reproductive Health Presented by Geeta Nanda (FHI 360) Co-Authors: Kara Tureski (FHI 360), Rachel Lenzi (FHI 360), Asi Burak (Games for Change), Paramita Dasgupta (Centre for Media Studies), Kalpana Bindu (Centre for Media Studies)

2. What is “Half the Sky”?

3. Background on Half the Sky (HTS) • Multi-donor, multi-media communication initiative inspired by best-selling book, Half the Sky: Turning Oppression into Opportunity for Women Worldwide, by Pulitzer Prize winning authors Nicholas Kristof & Sheryl WuDunn • Global movement celebrating and empowering women • Aims to heighten visibility of girls’and women’s issues and support efforts to affect positive change, focused on the following themes: • Economic empowerment • Girls’ education • Women and girls’ health • Gender-based violence • Sex trafficking

4. Today’s Presentation: USAID Investment in HTS under C-Change, FHI 360 • Increase ability of HTS Movement partner NGOs to engage their constituencies on key gender issues • Develop educational tools to help NGOs engage their communities around HTS Movement themes: • 18 advocacy/educational videos • 3 mobile games • HTS NGO capacity strengthening • Social media and mobile phone webinars and guidebook

5. Half the Sky Mobile Phone Games Mobile health and educational games offering direct impact for audiences most affected by the issues covered in the best-selling book

6. Worm Attack! • Worm Attack! • For kids 7 and older • Keep boys and girls healthy by defeating worms in their tummies

7. Family Choices • Family Choices • A fun interactive soap opera with dramatic elements • Combines simple action with narrative choices • Aimed at enhancing the perception of girls’value to families, with an emphasis on extending girls’ education

8. Nine Minutes • Nine Minutes • Play out the adventure of pregnancy and keep mother and her baby healthy • The 9-month process is compressed into a compelling game experience

9. Overview of Mobile Phone Games (Video Clip)

10. Evaluation of Nine Minutes Game Evaluation carried out in India in September -November 2012 Evaluation of Nine Minutes game in Delhi (knowledge, attitudes, perceptions, intention to act, relevance, acceptability) Exposure to game in evaluation setting; distribution of games had not yet begun Ethical approval received from IRBs in India and USA

11. Study Objective and Methods • Objective: to assess effects of game on knowledge, attitudes, perceptions, and intentions to act • Mixed methods with quantitative pre- and post-tests combined with qualitative focus group discussions • Study inclusion criteria: • Married women (ages 18-44) pregnant or intending to become pregnant within next year • Husbands (ages 21+) of women of reproductive age who were pregnant or intending to become pregnant within next year • Accessibility to a mobile phone

12. Background Characteristics and Media Exposure Pearson chi-square test: *p< .05, **p<.01, ***p<.001

13. Feedback on Nine Minutes Game – Women • 75.4% strongly agreed they enjoyed playing the game • 72.8% strongly agreed they would play the game if it was available to them in the future • Top 4 messages recalled from the game: • Visit facility for antenatal care • Take iron/IFA tablets • Save money for emergencies during pregnancy • Visit ASHA worker • 91.1% got new information from the game • 94.4% would recommend the game to others

14. Feedback on Nine Minutes Game – Men • 66.4% strongly agreed they enjoyed playing the game • 65.0% strongly agreed they would play the game if it was available to them in the future • Top 4 messages recalled from the game: • Visit facility for antenatal care • Visit ASHA worker • Take iron/IFA tablets • Save money for emergencies during pregnancy • 98.6% got new information from the game • 90.2% would recommend the game to others

15. FGD Feedback on Nine Minutes Mobile Phone Game “We enjoyed playing the mobile game and would love to play it again if given a chance. Other games are time pass only but this game is information with entertainment.” – (Male FGD participant) “I will talk about the game with my wife, brother, in my office, and especially to men whose family is expecting a baby.” – (Male FGD participant) “Another thing, we sometimes forget what the doctors say but in mobile game the information was given along with pictures so it would be easy to remember.”– (Female FGD participant) “In case my husband could not accompany me to doctor for ANC then I could explain him easily by showing this mobile game.”– (Female FGD participant)

16. Knowledge, Attitudes, and Intentions – Women Significant at ***p<.001

17. Knowledge, Attitudes, and Intentions – Men Significant at *p<.05, ***p<.001

18. Study Limitations • Evaluation conducted in restricted and controlled environment and not in context of ongoing intervention • Conducted in Delhi region only so not generalizable to other Indian contexts • Post-test carried out immediately following game-play; participants played game an average of 3 times

19. Mobile Games - Distribution Highlights and Next Steps • NGOs involved in disseminating games • Games available via the app stores of mobile phone providers • Free downloads of games via SMS messages • Games downloaded 45,047 times • Games for Change and Show of Force expanding activities in India and Kenya with new $2.5 million grant from USAID • Also partnering with Ford Foundation to promote gender equality globally, with a focused and intensive effort in India and Kenya

20. THANK YOU • For more information on C-Change activities, contact: Geeta Nanda gnanda@fhi360.org or Kara Tureski ktureski@fhi360.org • For more information on Games for Change, contact: Asi Burak asiburak@gamesforchange.org