Abstract
BackgroundThere are high expectations that mobile health (mHealth) strategies will increase uptake of health care services, especially in resource strained settings. Our study aimed to evaluate effects of an mHealth intervention on uptake of maternal health services. MethodsThis was an intervention cohort study conducted at six public antenatal and postnatal care clinics in inner-city Johannesburg, South Africa. The intervention consisted of twice-weekly informative and pregnancy stage-based maternal health information text messages sent to women during pregnancy until their child was one year of age. The intervention arm of 87 mother-infant pairs was compared to a control arm of 90 pairs. Univariate and multivariate analyses were used to compare the probability of the outcome between the two groups.ResultsIntervention participants had higher odds of attending all government-recommended antenatal and postnatal visits, all recommended first year vaccinations (OR: 3.2, 95% CI 1.63–6.31) and had higher odds of attending at least the recommended four antenatal visits (OR: 3.21, 95% CI 1.73–5.98).ConclusionWe show an improvement in achieving complete maternal-infant continuum of care, providing evidence of a positive impact of informative maternal mHealth messages sent to pregnant women and new mothers.Trial registration ISRCTN, ISRCTN41772986. Registered 13 February 2019—Retrospectively registered, https://www.isrctn.com/ISRCTN41772986
Highlights
There are high expectations that mobile health strategies will increase uptake of health care services, especially in resource strained settings
A difference in country of birth was noted with 45% of the intervention group being born in South Africa compared to 29% in the control group (p = 0.004)
The odds of achieving the primary outcome, completing the continuum of care, and receiving comprehensive care, were 3.2 times higher among intervention participants after adjusting for country of birth (OR = 3.2, 95% control Odds ratio (CI) 1.63–6.31, p = 0.007) (Table 3)
Summary
There are high expectations that mobile health (mHealth) strategies will increase uptake of health care services, especially in resource strained settings. Our study aimed to evaluate effects of an mHealth intervention on uptake of maternal health services. EPI programmes have been successful and immunization rates in the first year of life are high; rates for diphtheria, tetanus and pertussis (DTP) and polio immunization stood at 85% in 2019, with measles and Hepatitis B coverage at 85% and 85% respectively [8]. Patient-focused mHealth interventions have been shown to increase adherence to antiretroviral medication [11, 12], support patients with chronic diseases [13], and increase attendance to maternal and infant care services [14, 15]. There are knowledge gaps related to the implementation of mHealth interventions among pregnant women in many settings and detailed information on the type and structure of effective mHealth interventions is incomplete
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