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Mixed Method Evaluation of a Passive Health Sexual Information Texting Service in Uganda-Working Paper 332

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  • Julian 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 Jamison, Dean Karlan, Pia Raffler, 2013. "Mixed Method Evaluation of a Passive Health Sexual Information Texting Service in Uganda-Working Paper 332," Working Papers 332, Center for Global Development.
    • Handle: RePEc:cgd:wpaper:332
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    1. Alberto Chong & Marco Gonzalez-Navarro & Dean Karlan & Martín Valdivia, 2020. "Do Information Technologies Improve Teenagers’ Sexual Education? Evidence from a Randomized Evaluation in Colombia," The World Bank Economic Review, World Bank, vol. 34(2), pages 371-392.
    2. Karlan, Dean S. & Zinman, Jonathan, 2012. "List randomization for sensitive behavior: An application for measuring use of loan proceeds," Journal of Development Economics, Elsevier, vol. 98(1), pages 71-75.
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    5. Jenny C. Aker & Isaac M. Mbiti, 2010. "Mobile Phones and Economic Development in Africa," Journal of Economic Perspectives, American Economic Association, vol. 24(3), pages 207-232, Summer.
    6. Alberto Chong & Marco Gonzalez-Navarro & Dean Karlan & Martín Valdivia, 2020. "Do Information Technologies Improve Teenagers’ Sexual Education? Evidence from a Randomized Evaluation in Colombia," The World Bank Economic Review, World Bank, vol. 34(2), pages 371-392.
    7. Corstange, Daniel, 2009. "Sensitive Questions, Truthful Answers? Modeling the List Experiment with LISTIT," Political Analysis, Cambridge University Press, vol. 17(1), pages 45-63, January.
    8. Jalan, Jyotsna & Somanathan, E., 2008. "The importance of being informed: Experimental evidence on demand for environmental quality," Journal of Development Economics, Elsevier, vol. 87(1), pages 14-28, August.
    9. Robert Jensen, 2007. "The Digital Provide: Information (Technology), Market Performance, and Welfare in the South Indian Fisheries Sector," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(3), pages 879-924.
    10. Patricia N. Mechael, 2009. "The Case for mHealth in Developing Countries," Innovations: Technology, Governance, Globalization, MIT Press, vol. 4(1), pages 103-118, January.
    11. Gallant, Melanie & Maticka-Tyndale, Eleanor, 2004. "School-based HIV prevention programmes for African youth," Social Science & Medicine, Elsevier, vol. 58(7), pages 1337-1351, April.
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    Cited by:

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    2. 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.
    3. 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.
    4. Olivia Bertelli & Thomas Calvo & Massa Coulibaly & Moussa Coulibaly & Emmanuelle Lavallée & Marion Mercier & Sandrine Mesplé-Somps & Ousmane Z Traoré, 2023. "Collecting data on sensitive experiences and attitudes: a Malian case study [Collecter des données sur des expériences et attitudes sensibles : le cas du Mali]," Post-Print hal-04366322, HAL.
    5. 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.
    6. Sevin Kaytan & Stwarth Piedra-Bonilla & Tom Zohar, 2025. "The Complementary Role of Information and Contraceptive Access in Teen Pregnancy," Working Papers wp2025_2507, CEMFI.
    7. 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.
    8. De Cao, Elisabetta & Lutz, Clemens, 2014. "Sensitive survey questions," Research Report 14017-EEF, University of Groningen, Research Institute SOM (Systems, Organisations and Management).
    9. 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.

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    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

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