CycleTel(TM) in India: Effective Family Planning on Mobile Phones

With CycleTel™ now available in India, family planning is a text message away. CycleTel, a mobile health application developed by Georgetown University's Institute for Reproductive Health (IRH) with technical support from ThoughtWorks, Inc., supports use of the Standard Days Method® (SDM) of family planning (FP) by alerting a woman of her fertile days via short message service (SMS).

Proof-of-concept testing included focus group discussions (n=54), cognitive interviews (n=18), and manual testing with users (n=100) in two sites, Lucknow and Delhi. During manual testing, women used the service for 2 menstrual cycles and were interviewed at admission, follow-up, and exit. Findings from proof-of-concept testing—including feasibility, acceptability, message content and frequency, willingness-to-pay, and mobile phone usage trends—informed product feasibility and design. Following, we developed software to automate CycleTel, and launched a “test market” with 500 women. Data on service use/users was collected in real-time, viewable on a secure online database. We conducted intercept user interviews with a random sample of users, and exit interviews with women and their husbands at the end of 2 menstrual cycles of use.

Preliminary findings indicate that CycleTel is a feasible, effective innovation for offering SDM directly-to-consumers with potential for a substantial impact in India, in addition to other locations worldwide. Key recommendations include: 1) mHealth interventions require significant formative research before undergoing resource intensive technology development; 2) strong technology partnerships facilitate rapid development and deployment; and 3) bulk of time/effort is spent coordinating deployment infrastructure, and developing/implementing plans for evaluation, scale up and sustainability.