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Mixed Method Evaluation of a Passive mHealth Sexual Information Texting Service in Uganda

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  • Julian C. Jamison
  • Dean Karlan
  • Pia Raffler

Abstract

We evaluate the impact of a health information intervention implemented through mobile phones, using a clustered randomized control trial augmented by qualitative interviews. The intervention aimed to improve sexual health knowledge and shift individuals towards safer sexual behavior by providing reliable information about sexual health. The novel technology designed by Google and Grameen Technology Center provided automated searches of an advice database on topics requested by users via SMS. It was offered by MTN Uganda at no cost to users. Quantitative survey results allow us to reject the hypothesis that improving access to information would increase knowledge and shift behavior to less risky sexual activities. In fact, we find that the service led to an increase in promiscuity, and no shift in perception of norms. Qualitative focus groups discussions support the findings of the quantitative survey results. We conclude by discussing a potential mechanism explaining the counterintuitive findings.

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  • Julian C. Jamison & Dean Karlan & Pia Raffler, 2013. "Mixed Method Evaluation of a Passive mHealth Sexual Information Texting Service in Uganda," NBER Working Papers 19107, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:19107
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    Cited by:

    1. Katherine B. Coffman & Lucas C. Coffman & Keith M. Marzilli Ericson, 2017. "The Size of the LGBT Population and the Magnitude of Antigay Sentiment Are Substantially Underestimated," Management Science, INFORMS, vol. 63(10), pages 3168-3186, October.
    2. Cohen, Jessica & Saran, Indrani, 2018. "The impact of packaging and messaging on adherence to malaria treatment: Evidence from a randomized controlled trial in Uganda," Journal of Development Economics, Elsevier, vol. 134(C), pages 68-95.
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    4. M. Niaz Asadullah & Elisabetta De Cao & Fathema Zhura Khatoon & Zahra Siddique, 2021. "Measuring gender attitudes using list experiments," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(2), pages 367-400, April.
    5. Dirk-Jan Koch & Jolynde Vis & Maria van der Harst & Elric Tendron & Joost de Laat, 2021. "Assessing International Development Cooperation: Becoming Intentional about Unintended Effects," Sustainability, MDPI, vol. 13(21), pages 1-26, October.
    6. Lépine, Aurélia & Treibich, Carole & D’Exelle, Ben, 2020. "Nothing but the truth: Consistency and efficiency of the list experiment method for the measurement of sensitive health behaviours," Social Science & Medicine, Elsevier, vol. 266(C).
    7. Dupas, Pascaline & Huillery, Elise & Seban, Juliette, 2018. "Risk information, risk salience, and adolescent sexual behavior: Experimental evidence from Cameroon," Journal of Economic Behavior & Organization, Elsevier, vol. 145(C), pages 151-175.
    8. Blattman, Christopher & Jamison, Julian & Koroknay-Palicz, Tricia & Rodrigues, Katherine & Sheridan, Margaret, 2016. "Measuring the measurement error: A method to qualitatively validate survey data," Journal of Development Economics, Elsevier, vol. 120(C), pages 99-112.
    9. Gutierrez, Emilio & Rubli, Adrian, 2024. "LGBT+ persons and homophobia prevalence across job sectors: Survey evidence from Mexico," Labour Economics, Elsevier, vol. 87(C).
    10. Olivia Bertelli & Thomas Calvo & Emmanuelle Lavallée & Marion Mercier & Sandrine Mesplé-Somps, 2023. "Measuring insecurity-related experiences and preferences in a fragile State. A list experiment in Mali," Working Papers DT/2023/01, DIAL (Développement, Institutions et Mondialisation).
    11. Aksoy, Billur & Carpenter, Christopher S. & Sansone, Dario, 2022. "Understanding Labor Market Discrimination against Transgender People: Evidence from a Double List Experiment and a Survey," IZA Discussion Papers 15542, Institute of Labor Economics (IZA).
    12. Carole Treibich & Aurélia Lépine, 2019. "Estimating misreporting in condom use and its determinants among sex workers: Evidence from the list randomisation method," Health Economics, John Wiley & Sons, Ltd., vol. 28(1), pages 144-160, January.
    13. Evan Borkum & Anitha Sivasankaran & Swetha Sridharan & Dana Rotz & Sukhmani Sethi & Mercy Manoranjini & Lakshmi Ramakrishnan & Anu Rangarajan, 2015. "Evaluation of the Information and Communication Technology (ICT) Continuum of Care Services (CCS) Intervention in Bihar," Mathematica Policy Research Reports 2e2826deedb94ee18890653d8, Mathematica Policy Research.
    14. Amber Peterman & Tia M. Palermo & Sudhanshu Handa & David Seidenfeld & on behalf of the Zambia Child Grant Program Evaluation Team, 2018. "List randomization for soliciting experience of intimate partner violence: Application to the evaluation of Zambia's unconditional child grant program," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 622-628, March.
    15. Juliane Zenker & Andreas Wagener & Sebastian Vollmer, 2018. "Better Knowledge Need Not Affect Behavior: A Randomized Evaluation of the Demand for Lottery Tickets in Rural Thailand," The World Bank Economic Review, World Bank, vol. 32(3), pages 570-583.
    16. Dupas, Pascaline & Miguel, Edward, 2016. "Impacts and Determinants of Health Levels in Low-Income Countries," Department of Economics, Working Paper Series qt3r04k69j, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    17. Jorge M. Agüero & Veronica Frisancho, 2022. "Measuring Violence against Women with Experimental Methods," Economic Development and Cultural Change, University of Chicago Press, vol. 70(4), pages 1565-1590.
    18. Yang, Dean & Allen, James & Mahumane, Arlete & Riddell, James & Yu, Hang, 2023. "Knowledge, stigma, and HIV testing: An analysis of a widespread HIV/AIDS program," Journal of Development Economics, Elsevier, vol. 160(C).
    19. Bamberger, Michael & Tarsilla, Michele & Hesse-Biber, Sharlene, 2016. "Why so many “rigorous” evaluations fail to identify unintended consequences of development programs: How mixed methods can contribute," Evaluation and Program Planning, Elsevier, vol. 55(C), pages 155-162.
    20. Elisabetta de Cao & Clemens Lutz, 2015. "Measuring attitudes regarding female genital mutilation through a list experiment," CSAE Working Paper Series 2015-20, Centre for the Study of African Economies, University of Oxford.
    21. Cullen,Claire Alexis, 2020. "Method Matters : Underreporting of Intimate Partner Violence in Nigeria and Rwanda," Policy Research Working Paper Series 9274, The World Bank.
    22. Bertelli, Olivia & Calvo, Thomas & Lavallée, Emmanuelle & Mercier, Marion & Mesplé-Somps, Sandrine, 2024. "What one thinks, what one says and what one does: male justifications and practices of gender-based violence in Mali," CEPREMAP Working Papers (Docweb) 2406, CEPREMAP.
    23. De Cao, Elisabetta & Lutz, Clemens, 2014. "Sensitive survey questions," Research Report 14017-EEF, University of Groningen, Research Institute SOM (Systems, Organisations and Management).

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    More about this item

    JEL classification:

    • D13 - Microeconomics - - Household Behavior - - - Household Production and Intrahouse Allocation
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O31 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Innovation and Invention: Processes and Incentives
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes

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