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Kiosks linked to declining mortality rate among Indian babies

February 23, 2011

Internet kiosks, not strong social ties in rural villages, have helped reduce infant, child and maternal mortality rates in India, according to a study recently published by a researcher at the University of Arkansas.

Internet kiosks deployed throughtout several villages in India have been providing mothers with prenatal and postnatal care information since 2004.

"Based on our knowledge of religious beliefs and various customs within rural Indian culture, as well as the basic tendency of people to associate and bond with others similar to themselves, we hypothesized that strong network ties would be detrimental to women seeking good information about health care," said Viswanath Venkatesh, study author and professor in the Sam M. Walton College of Business. "The results of this study provided evidence that this was indeed the case. Women with strong network ties seemed to be influenced by strong pressure not to change traditional practices and customs."

India's high infant mortality rates – approximately 55 per 1,000 live births – and child mortality rates – 78 per 1,000 live births – led to several private organizations installing Internet kiosks to provide information about prenatal and postnatal care for mother and baby. The kiosks are public Internet stations, similar to those found in a library or café, where rural Indians can gain access to the World Wide Web.

Venkatesh and former doctoral student Tracy Sykes, now assistant professor at the Australian National University, conducted a five-year study of women in 20 rural villages, 10 with Internet kiosks and 10 with no such intervention. They used surveys and health records from government archives to gather data. A general survey was taken at the deployment of each kiosk. In each village, about 300 women participated.

From 2004 to 2009, infant and child mortality rates in both groups decreased, but overall the intervention group – those villages with Internet kiosks – experienced a more rapid decline. In 2004, the year the Internet kiosks were installed, overall mortality rates were about the same number – 68 per 1,000 live births. Below are results from an equally weighted index of infant, child and maternal mortalities over the five-year period:

The percentage of women using the kiosks was only 4.8 percent in 2004 but was rising steadily each year to 8.8 percent in 2009. Venkatesh said this information was valuable because it showed that the transfer of information about health issues depended not only on the kiosk but also on women's ties to other women who had used them.

Venkatesh and Sykes tested the classic social network hypothesis, which argues that strong ties among community members result in positive social benefits. In this case, they found the opposite, that strong community ties among women in the villages were associated with negative effects on them seeking health information and medical care. They found positive effects – access to health information and medical care – for women with weak community ties.

"Mortality rates in rural India have shown a steady decline, which is great," Venkatesh said. "But it's important to dig a little deeper and find out why. We have empirical evidence of the positive impact of Internet kiosks and, perhaps counterintuitively, both the detrimental effects of a strong social network and positive effects of a weak network."

Venkatesh presented these results to a United Nations panel of experts on gender, science and technology. At a conference in Paris, the group explored gender dimensions of science and technology and identified policies and programs to accelerate progress toward Millennium Development Goals.