Realised by Valéry Ridde, Emmanuel Bonnet, Christian Dagenais, Ludovic Queuille, Zoumana Traoré, Patrice Sanon, Lucie Lechat and Paul-André Somé. Presented at the 22nd IUHPE World Conference for health promotion in Curitiba, Brazil (May 2016).

1. AN ACTION RESEARCH PROJECT PROVIDING
A TOLL-FREE NUMBER USING AN
INTERACTIVE VOICE SERVER FOR HEALTH
SERVICES USERS AND PROFESSIONALS TO
IMPROVE HEALTH SYSTEM GOVERNANCE IN
BURKINA FASO
Ridde V., Bonnet E. Dagenais C. Queuille L., Traore Z. Sanon P. Lechat L. Somé P-A.
May 25, 2016
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2. CONTEXT
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• Democratization of Mhealth in LMIC
• Low reactivity of health system in LMIC and Burkina Faso
• Exploratory research in Burkina
– Scoping review, Indian experimentation, interviews and
workshops
• Burkina Faso Health Policies Orientations :
• Promotion of democracy and improvement of active
citizenship
• Improve the good governance and ICT potential for
development
• Improve the health service and governance

3. ACTION RESEARCH
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• Action research approach, reflexivity and partnership
• Toll free number with Interactive Voice Response (IVR)
• Health staff and patients
• Improve the governance, health services and health system
responsiveness
• Research objective :
• to experiment and evaluate the technical, social and
instrumental relevance of an automatic toll free number
with 2 different technologies

4. CONCEPT
• 11 sectors in the capital (500.000 hab., < 100 health centre)
• PFT = Toll free number + IVR multilingual + web
• Information and communication activities
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4POPULATION + « AS »
AIRTELONATEL TELECEL TELMOB
(ARCE)
TOLL FREE NUMBER
(ONATEL)
ANONYMUS AND FREE CALL
INTERACTIVE VOICE RESPONSE
DATA BASE
Zone d’intervention

5. INTERVENTION
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• Ph1 : health system performance, health system delivery, financial access
• Ph2 : 2 MCQ : health staff and health users
PHASE 1 (PH1)
1 CLOSE QUESTION + 1 OPEN QUESTION
KEYBORD TOUCH + MESSAGE RECORDING
(2 MINUTES)
3 MONTHS
PHASE 2 (Ph2)
MULTIPLE CHOICE QUESTIONS
+ 1 OPEN QUESTION
KEYBORD TOUCH
(2 - 5 minutes)
3 MONTHS
CONTENT
ANALYSIS

6. RELEVANCE EVALUATION
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• TECHNOLOGIC : A technical solution adapted ?
• SOCIAL/CONTEXT : Adapted to the social context ?
• INSTRUMENTAL : Useful data to improve HS respons. ?
DATA COLLECTED :
 2364 messages recorded (Ph1)
 1328 questionnaires filled (Ph2)
 247 questionnaires (Ph1)
 44 interviews (Ph2)

7. TECHNOLOGIC
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Phase 1 (Ph1) Phase 2 (Ph2)
124 DAYS 154 days (49 non functional)
9966 CALL 3911 CALL
578 CALL/WEEK (M.) 261 CALL/WEEK (M.)
DURATION : 44 s (M.) DURATION : 1’45s
AUDIBLES MESSAGES
(less noisy than expected)
AUTOMATIC DATA COLLECTION
0
500
1000
1500
2000
2500
N CALL PER WEEK
(Ph1)
MOORE INTERVIEW IN
A LOCAL RADIO
0
100
200
300
400
500
600
N CALL PER WEEK (Ph2)

8. INSTRUMENTAL
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PHASE 1 (Ph1) PHASE 2 (Ph2)
USERS > STAFF
USERS (68%) > H Staff
(Under 5 Y. or public health
facilities adults)
Infrastructures, welcome,
HR, caring, payment,
medical inputs
Good satisfaction but not for
payment for users and
health services for staff
Others topics :
• TEST, CLARIFICATION, WELCOME,
SUGGESTIONS
• PERSONNAL HEALTH PROBLEM
HEALHT INFORMATION NEEDS
(HIV/AIDS, etc.)
39%
18%
18%
25%
USERS
Avis très positifs
Avis positifs
Avis négatifs
Avis très négatifs
47%
27%
26%
PATIENTS AGE
Un enfant de plus de
5ans ou un adulte
Femme enceinte ou
mère d'un enfant de
plus de deux ans
Enfant de moins de 5
ans

9. SOCIAL
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PHASE 1 (PH1) PHASE 2 (PH2)
CALL PICS : RADIO
(990 in few hours)
CALL PICS : RADIO
(134 in 1 day)
49% RECORDED
MESSAGES
48% QUIZ STARTED
1/3 VALID CONTENT
49% HAVE CHOSEN A
LANGUAGE
FINISH THE QUIZ :
30% OF USERS
15% FOR HEALTH STAFF
• LEARNING CURVES ?
• STAFF HAVE LESS TIME THAN USERS ?
73%
21%
6%
LANGUAGE (ph2)
Mooré
Français
Dioula
61%
30%
9%
LANGUAGE (Ph1)
Mooré
Français
Dioula

10. CONCLUSION
TECHNO
• ABILITY TO DEVELOP AND IMPLEMENT A TOLL FREE NUMBER WITH 2 TECHNOLOGIES
SOCIAL
• GOOD INTEREST FROM USERS AND HEALTH STAFF
• USERS ARE MORE PATIENTS FROM PUBLIC HEALTH FACILITY
• MULTILINGUAL AND COMMUNICATIONS ARE KEY
• ECONOMIC CONTEXT IS CHALLENGING (ELECTRICITY, INTERNET, PHONE, ETC)
INSTRUMENTAL
• DATA COLLECTED, VALID AND A GOOD POTENTIAL TO BE USED
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11. equitesante.org
@equitesante
Merci de votre attention
Nous remercions aussi le Ministère de la Santé, les différentes autorités sanitaires IGS,
DRS, DS), FS, AS, OSC, etc.), les décideurs, techniciens, opérateurs, représentants Société
civile, chercheurs, etc.), la population, etc.

12. CHALLENGES
… Pertinence technologique
o Nécessité de matériels ou d’une structure d’hébergement de la plateforme
SVI adaptée pour pallier les défauts de fourniture en énergie
o Besoin de proposer un service en plusieurs langues
… Pertinence sociale
o Importance des activités de communication/information
o Besoin de recherche approfondie sur les raisons des erreurs de manipulation
et d’abandon
o Besoin de recherche sur une mise en service en milieu rural
… Pertinence instrumentale
o Charge de l’analyse de contenu des messages enregistrés non viable pour le
passage à l’échelle du concept
o Formulaire trop long
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