Shinde, Aashaka

School of Public Health

MSPH

India

Kilkari Impact Evaluation (Qualitative)

There are 5 maternal messaging programs globally which have scaled to over 1 million users; Kilkari is the largest of these in terms of absolute numbers. Kilkari is an outbound health service that delivers weekly, stage-based audio messages about pregnancy, childbirth, and childcare directly to families in 13 states across India on their mobile phones. With support from the Gates Foundation, JHSPH in collaboration with the University of Cape Town, Oxford Policy Management (OPM), and BBC Media Action, is the leading an evaluation of Kilkari. Activities include a randomized controlled trial across 4 districts of MP state; big data analytics of secondary data; qualitative research; and an economic evaluation. 

PI Mentor: Kerry Scott

As a part of my GHEFP, I worked on the Kilkari impact evaluation in central India. I started my field placement in India feeling very confident since it is my home country. I had expected that I would not experience a hard culture shock given that I grew up in India and knew its cultural norms. However, moving through the villages of central India taught me that you can experience culture shock even within your own home country. On one side, I saw young women in rural India being afforded freedoms and allowed behaviors such as wearing western clothing and leaving the village to study alone in cities that I had not expected to see at all. On the flip side, I was required to adhere to norms and perform behaviors that reduced my mobility and required me to dress in a certain way, which I had never had to do before, growing up in larger cities of India. These things came as a surprise, to which I had to quickly adapt, forcing me to learn new things about my home country. 

During my placement, I largely worked with the team to develop and translate data collection tools, and to collect qualitative data. Being a part of the process of developing and administering a data collection tool highlighted many small but important things for me, starting from the realization that developing tools for data collection in isolation from field realities could lead to tools and guides that are difficult to work with in the field, even for the most experienced data collectors and that garnering input on tools from data collectors is very important to the tool development process.

 It also showed me that using tools without first checking if they were appropriate for the context and the population could lead to frustrating experiences for data collectors, as well as low-quality data. This was made apparent to me, when, during the placement, I worked with the team that was developing data collection tools and conducting qualitative research. Being a native Hindi speaker, I could actively participate in the fieldwork and aid the process of data collection by being a part of the field team that was conducting in-depth interviews. One of the most frustrating yet enlightening episodes of this placement came during data collection, when we tried to use a tool that was thought to be universal to the practice of public health with the participants of the study. It was surprising to learn that a tool that was used regularly in the field of public health with great success was difficult to explain and use in the rural Indian context. 

This experience has also helped me gain a variety of skills, including running a training workshop for data collectors, negotiating ethical dilemmas in the course of in-depth interviews and dealing with insect bites in the middle of nowhere, when I was careless enough to walk the path less taken. It has also taught me that no task is too small, and that notepads and pens are the key to maintaining sanity when doing fieldwork in low resource environments, where electricity and internet are a luxury. This field placement has made me a lot more confidence in my skills as a public health practitioner and taught me that even the most familiar of places can present challenges when your role within those spaces, changes. 

Finally, it has helped me understand how mHealth programs and their impact evaluations were run in the field and has led me to the realization that I would like to continue working on impact evaluations post the completion of my graduate studies. 

Attending and observing trainings for endline survey administrators.

Understanding how IFA syrup quantities are measured for infants by FLHWs.

Mining and land erosion observed enroute to a field site in rural Central India.

Measuring a container against a pen for scale to understand recommended food portion sizes according to government guidelines for infants in India.

A large well at a field site in rural Central India.

Walking to a study participant’s house in a village that is not connected to any motorable roads in rural Central India.

People

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation
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