Abstract
Group-based health services can improve maternal and newborn health outcomes. Group antenatal care and participatory learning and action cycles (PLA) with women's groups have been cited by the WHO as health systems interventions that can lead to improvements in adherence to care and health outcomes in pregnancy and the postpartum period. We used a mixed-methods approach to assess the feasibility of a light touch group-based support intervention using the WhatsApp text-messaging platform. Pregnant women were enrolled at Jacaranda Health (JH), a maternity center in peri-urban Kiambu County, Kenya. Their phone numbers were added to WhatsApp groups consisting of participants with similar estimated due dates. The WhatsApp group administrator was a JH employee. Acceptability, demand, implementation, and practicality of this service were evaluated through in-depth interviews (IDIs), surveys, chart review, and analysis of group chats. Limited analysis of program efficacy (ANC visits, any PNC, and post-partum family planning uptake) was assessed by comparing participant data collected through chart review using a concurrent comparison of the general JH patient population. Fifty women (88%) of 57 eligible women who were approached to participate enrolled in the study. Five WhatsApp groups were created. A total of 983 messages were exchanged over 38 weeks. No harms or negative interactions were reported. Participants reported several benefits. Participants had differing expectations of the level of the group administrator's activity in the groups. ANC and PNC attendance were in line with the hospital's metrics for the rest of JH's patient population. Higher rates of postpartum long acting reversible contraception (LARC) uptake were observed among participants relative to the general patient population. A moderated mobile-based support group service for pregnant women and new mothers is safe and feasible. Additional research using experimental designs to strengthen evidence of the effectiveness of the support intervention is warranted.
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