The VALID mHealth virtual counseling intervention
anemia, COVID-19 infection
MAY, ANEMIA, COVID-19 INFECTION
We implemented virtual counseling (VC) through a Zoom communications platform on mobile devices from 23rd January to 6th May 2022 in rural plains Nepal when COVID-19 infection rates were low. We provided two VC sessions to married pregnant women aged 13–49. The first session was given between 12 and 28 weeks of pregnancy. We aimed to provide the second VC at least 14 days from the first VC. Informed by formative research, we developed a dialogical counseling guide for use by trained counselors to virtually engage pregnant women and their family members in discussions about anemia prevention. The guide was informed by Freire’s empowerment education model which proposes a ‘listening-dialogue–action’ approach [In the second VC, the counselors used a similar approach which started by discussing what had been successful and what had been challenging while implementing the action plan. Then, the counselors read another story which covered different issues from the first story. The story was then used to trigger discussion and development of a revised action plan.The intervention was implemented by 10 female counselors who were qualified as auxiliary nurse midwives, or graduates with more than 4 years’ experience implementing health and nutrition interventions in the community. Most of them were from the local area and all spoke Awadhi and Nepali languages. Counselors received six days of training on anemia and nutrition during pregnancy, interpersonal communication, and using the guide to facilitate VC. They learned how to use mobile devices and Zoom, and how to teach pregnant women over the phone about their device. We used role plays of how to use the counseling guideline based on examples from formative research. Each counselor conducted eight role plays during training and one with community women who were not pregnant but had had children within the last year.