When parents have questions about their children’s nutrition, this chatbot has the answers they need
A UNICEF pilot programme is helping to facilitate critical nutrition information between families and health workers.
KUPANG, Indonesia – Micke Mbotu thought her two children always had enough to eat. But during a visit to the health centre, she was in disbelief when her 17-month-old daughter Felicity was diagnosed with severe wasting – the most dangerous form of child malnutrition – and required urgent treatment.
“I couldn’t accept it,” said Micke. “I gave my children good food. I even added some other nutritious ingredients to their porridge so it was never empty.”
At the time of the visit, Felicity only weighed 6.5 kg, below the normal weight of 7.2 kg for a child her age. Yeni Haning, the nutritionist at the health centre, noticed that Felicity’s condition caused her mood to swing from lively and smiling to cranky and fussy. To help her gain weight, Yeni gave Micke a package of Ready-to-Use Therapeutic Food (RUTF), a peanut-based paste used to treat severely wasted children.
At first, Micke and her husband had limited knowledge on how to care for their severely wasted child. And due to the COVID-19 pandemic social restrictions, it was not possible for them to bring Felicity back to see Yeni at the health centre.
With many families facing similar situation, an innovative solution is essential to continuously support nutrition intervention. In East Nusa Tenggara province, health workers and care givers are using a WhatsApp chatbot application determined to provide critical nutrition support to families. This intervention was first piloted by UNICEF and the local government of Kupang Municipality, one of 22 districts and municipalities in the province with a high prevalence of malnutrition.
The WhatsApp chatbot, developed using RapidPro, provides parents and health workers with an online counselling platform to discuss children’s health and nutrition. It also gives families access to resources and information to ensure their children get the best nutrition possible. Users could easily input a keycode to select their desired nutritional topic by their mobile phone and receive the respective information in text, video or audio format. The chatbot also collects location data of caregivers for further nutritional intervention by respective health workers.
“Cases of severe wasting often stem from a lack of information as many parents and caregivers are not aware of the symptoms, causes and consequences,” said Blandina Rosalina Bait, UNICEF Indonesia Nutrition Specialist. “Even if they suspect their children may be too thin, many parents avoid bringing them to a health facility for fear of being accused of neglect.”
When families do seek help, only the mother usually goes to the health centre with their children, which can lead to other family members rejecting the treatment.
“Sometimes when the mothers go home and give the RUTF to their children, they face resistance from their husbands or mothers-in-law who don’t know the ingredients and benefits of RUTF,” Yeni explained. “In the chatbot, not only the mother but other family members can access detailed information and videos on RUTF. This helps them to understand and support the RUTF treatment.”
Micke’s husband initially thought the RUTF wasn’t enough for Felicity and wanted to give her infant or follow-up formula instead. But after reading the information provided through the chatbot, Micke was able to convince him to accept the diagnosis and treatment.
“I’m happy with the chatbot because it gives me knowledge,” she said.
After being treated with the RUTF for five weeks, Felicity is now at a healthy weight. Micke is proud to see her daughter growing well and notices a significant change in her appearance and behaviour.
“I’m happy with the chatbot because it gives me knowledge."
“Physically, Felicity looks fuller and can play by herself,” Micke observed. “She used to get the flu, a fever or a cough but she has been healthy.”
While Felicity’s diagnosis left Micke feeling downbeat, her daughter’s progress has made her more hopeful as she is about to turn two years old.
“I won’t force her to be something. I just want her to be blessed during her growth so she can be healthy, smart and able to fulfil her dreams,” she said.