Impact Evaluation of Triggerise's Tiko Platform

Network for Engineering and Economics Research and Management

Status: Completed

Conditions: Contraception; Postnatal Care; Antenatal Care; Iron Deficiency Anemia of Pregnancy

Treatments: Behavioral: Tiko Platform Behavioural cum mHealth Intervention; Other: Standard of Care / Business as Usual

Study type: Interventional

Funder types: Other

Identifiers

NCT05725278

Triggerise Protocol V2

Details and patient eligibility

About

Triggerise designed web and phone based Tiko platform to connect young girls and women to the health products, services and information. The platform uses principles of behaviour economics to motivate positive choices-including rewards, promotions, discounts, coupons, reminders, alerts etc. The platform was implemented in several cities from seven states of India to provide Sexual Reproductive Health (SRH) and maternal and child health (MCH) products and services. The consumers (called Rafikis) use Tiko card to get discounts and to earn 'Tiko miles' rewards at Tiko franchised healthcare providers and pharmacies. Tiko miles are redeemable towards lifestyle products or services (e.g., beauty salons). The local Tiko health promoter (celled Pro agent) can also buy health and hygiene products at bulk discounts and sell them at profit.

Triggerise appointed Network for Engineering, Economics Research and Management (NEERMAN) to conduct an independent impact assessment of the Tiko platform with multiple research objectives include health impact evaluation at the Rafiki level.

NEERMAN used an ex-post observational design to compare usage of SRH and MCH services and family planning (FP), antenatal care (ANC) and postnatal care (PNC) practices by comparing Users and Non-Users of Tiko platform, and accounting for the selection bias statistically. The structured questionnaire collected data on knowledge, practices, barriers, enablers for SRH and MCH services, exposure o Tiko platform, and how it helped or did not help. The survey participants were approx. 1200 users and 600 non-users being served by approx. 350 pro-agents in their respective operations area.

The association between use of Tiko platform and various outcomes were identified using a generalized linear model with fixed effects at pro-agent level and including a set of covariates. To evaluate the effect modification by type of pro agent - government community health worker (CHW) versus others - an interaction model was used. The standard errors were automatically clustered at pro-agent level due to fixed effects. Primary outcomes are proportion of married Rafikis currently using any contraceptives, currently using modern short-term contraceptives, proportion of Rafikis who delivered a child post Jan 2019 and received at least 4 ANC check-ups, consumed at least 100 iron folic acid (IFA( during pregnancy, and received a PNC check-up within 6 weeks of birth.

Full description

See subsequent sections

Enrollment: 1,708 patients

Sex: Female

Ages: 18 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Women who are registered on Tiko Platform with Pro-agents active in 2020-21
• Age 18-50
• Address and contacts details are found with help of Pro-agent

Exclusion criteria

• Does not consent to participation
• Does not agree or confirm registering on Tiko Platform
• If a woman is never married, she is excluded from survey on family planning but surveyed for use of Tiko platform
• If a married woman does not have a child born on/after 1 January 2019, then she is excluded from the survey on antenatal care, delivery and postnatal care but surveyed for use of Tiko platform

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1,708 participants in 2 patient groups

Users of Tiko Platform

Experimental group

Description:

These participants accessed various services on Tiko platform such as buying contraceptives, visiting doctors for ANC etc. They earned Tiko Miles/Points for such health seeking behaviours which they could then redeem at network of grocery shops, pharmacies, beauty salon etc. Tiko card also enabled them to get discounts at pharmacies and at health care providers. These participants were free to access any other government or private health care facility as free economic agents. Users of Tiko platform were identified by the backend system that recorded all health seeking behaviours / actions, reward point accumulation, and use of those reward points.

Treatment:

Behavioral: Tiko Platform Behavioural cum mHealth Intervention

Non-Users of Tiko Platform

Active Comparator group

Description:

These participants registered on Tiko platform on basis of recruitment drive and pitch by Pro agents, but they did not access any service and became dormant. However, These participants were free to access any other government or private health care facility and could access fame family planning and ANC products and services. They could even access Tiko network doctors and pharmacies but they would not get any Tiko Miles/Points or discounts without the use of Tiko card. Non Users were identified as those registered women who did not have any record of using services using Tiko card as per the backend system

Treatment:

Other: Standard of Care / Business as Usual