Abstract
Introduction: Public health interventions such as text messaging are commonly evaluated in high-income countries and that the evaluation reports of the effectiveness of community health volunteers in low-income countries like Nepal is scarce. This study aimed to determine whether female community health volunteer (FCHV) capacity building and text messaging to expectant mother increases gestational weights and hemoglobin levels of pregnant women living in southern Nepal.Methods: A cluster randomized control trial was carried out in 52 clusters of 6 Village Development Committees in southern Nepal between July 2015 and March 2016. A total of 413 pregnant mothers of gestation age between 13 and 28 weeks (214 in the intervention group and 199 in the control group) were included in the analysis. Intervention consisted of FCHV capacity building followed by regular supervision and monitoring and mobile phone text messaging to expectant mothers. Regression analysis, controlled for confounders, was conducted to assess gestational weight gains and changes in hemoglobin levels.Results: At the end of the pregnancy, the mean weight gain difference between the intervention and control groups was 1.1 kg (95% CI: 1.0, 1.9). Rates of weight increases in the intervention and control groups were 0.504 kg/week (95% CI: 0.371, 0.528), and 0.399 kg/week (95% CI: 0.362, 0.465), respectively. Similarly, the mean inter group difference in hemoglobin levels was 0.11 gm/dl (95% CI: 0.09, 0.15), and rates of hemoglobin increases (gm/dl/week) in the intervention and control groups were 0.02 gm/dl (95% CI: 0.01, 0.09) and 0.004 gm/dl (95% CI: 0.02, 0.12), respectively.Conclusions: The study shows that FCHV capacity building and mobile text messaging have a positive effect on the gestational weights and hemoglobin levels of expectant mothers. Our findings suggest that mobile text messaging coupled with FCHV capacity building services should be supported and would usefully expand in resource poor settings.Trial registration: ISRCTN60684155.
Highlights
Public health interventions such as text messaging are commonly evaluated in high-income countries and that the evaluation reports of the effectiveness of community health volunteers in low-income countries like Nepal is scarce
Prior studies being conducted in developing countries demonstrated that the capacity enhanced community health volunteers can contribute to improve maternal and child health (MCH) status [9,10,11], while other studies from both of developing and developed countries reported the effectiveness of text messaging interventions to increase health service utilization rates and MCH status [12,13,14,15,16]
Hemoglobin level significantly differs among pregnant women having higher level of education [mean (SD): 11.89 mg/dl (0.90 mg/dl) vs. 11.16 mg/dl (1.02 mg/dl) in intervention and control group, respectively; p = 0.012] (Table 6). In this community-based cluster randomized controlled trial, we found that capacity building of female community health volunteers coupled with mobile text messaging to pregnant women significantly increased gestational weights and serum hemoglobin levels as compared to matched controls
Summary
Public health interventions such as text messaging are commonly evaluated in high-income countries and that the evaluation reports of the effectiveness of community health volunteers in low-income countries like Nepal is scarce. This study aimed to determine whether female community health volunteer (FCHV) capacity building and text messaging to expectant mother increases gestational weights and hemoglobin levels of pregnant women living in southern Nepal. Prior studies being conducted in developing countries demonstrated that the capacity enhanced community health volunteers can contribute to improve maternal and child health (MCH) status [9,10,11], while other studies from both of developing and developed countries reported the effectiveness of text messaging interventions to increase health service utilization rates and MCH status [12,13,14,15,16]. Avery et al concluded that enhancing the capacity and effectiveness of community health volunteers positively impacted the utilization of maternal and child care services in Kenya [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
