Effectiveness and Appropriateness of mHealth Interventions for Maternal and Child Health: Systematic Review

Chen, Huan; Chai, Yanling; Dong, Le; Niu, Wenyi; Zhang, Puhong

doi:10.2196/mhealth.8998

Cited by 142 publications

(134 citation statements)

References 30 publications

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“…This recruitment process can limit the availability of information about the recipient, and thus make the development of individualized messages difficult. Furthermore, most maternal and child mHealth interventions are without a focus on continuity of care [7]. Developing and sending TCC interventions from a longitudinal registry environment, that includes dynamic information over the course of pregnancy and delivery, to our knowledge, has not been reported previously.…”

Section: Development Of An Effective Tcc Intervention Is Complex and mentioning

confidence: 98%

“…Message content, in most mHealth interventions, tends to be generic and is rarely tailored towards important individual characteristics [7,8,14], possibly due to on-demand recruitment through campaigns documenting a few background information, especially in low-and middle-income countries [3]. This recruitment process can limit the availability of information about the recipient, and thus make the development of individualized messages difficult.…”

Section: Development Of An Effective Tcc Intervention Is Complex and mentioning

confidence: 99%

“…Targeted Client Communication (TCC) via SMS is being used to improve people's knowledge and attitudes towards healthy behaviors and utilization of healthcare services [6][7][8][9]. Targeted Client Communication, in this context, is defined as transmission of unidirectional targeted health content (pregnancy related information and appointment reminders) tailored to individuals, based on static and dynamic information about recipients from a routine maternal and child health registry system (adapted from World Health Organization [3], and Agarwal et al [10]).…”

Section: Introductionmentioning

confidence: 99%

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Development of a targeted client communication intervention to women using an electronic maternal and child health registry: a qualitative study

Bogale

Mørkrid

O’Donnell

et al. 2019

Preprint

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Background Targeted client communication (TCC) using text messages can inform, motivate and remind pregnant and postpartum women of timely utilization of care. The mixed results of the effectiveness of TCC interventions points to the importance of theory based co-design with users. Our aim is to describe the planning, development, and evaluation of a theory based TCC intervention, tailored to pregnant and postpartum women, and automated from an electronic maternal and child health registry in Palestine. Methods We used the Health Belief Model to develop interview guides to explore women’s perceptions of antenatal care (ANC), with a focus on high-risk pregnancy conditions (anemia, hypertensive disorders in pregnancy, gestational diabetes mellitus, and fetal growth restriction) and timely ANC attendance, issues predefined by a national expert panel as being of high interest. We performed 18 in-depth interviews with women and eight with healthcare providers in public primary healthcare clinics in the West Bank and Gaza. Following the results from the Health Belief Model, we used concepts from the Model of Actionable Feedback, social nudging and Enhanced Active Choice to compose the TCC content to be sent via SMS. We assessed the acceptability and understandability of the draft text messages through unstructured interviews with local health promotion experts, healthcare providers, and pregnant women. Results We found low awareness of the importance of timeliness in attending ANC and the benefits of ANC for pregnancy outcomes. We identified knowledge gaps and beliefs in the domains of low awareness of susceptibility to, and severity of, such complications in pregnancy. We composed actionable text messages following recommended message framing models and iteratively improved the contents with users to bridge the identified gaps. We developed algorithms to trigger tailored text messages with higher intensity for women with a higher risk profile. Conclusions: We developed an optimized text message based TCC intervention underpinned by behavior change theories and co-designed with users following an iterative process. The effectiveness of the TCC intervention is assessed in a cluster-randomized trial (ISRCTN10520687).

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Section: Development Of An Effective Tcc Intervention Is Complex and mentioning

confidence: 98%

Section: Development Of An Effective Tcc Intervention Is Complex and mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Development of a targeted client communication intervention to women using an electronic maternal and child health registry: a qualitative study

Bogale

Mørkrid

O’Donnell

et al. 2019

Preprint

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“…These studies showed promising ndings for the mhealth technology in general and for maternal healthcare services in particular. A similar review which identi ed 51 RCTs, documented that more than half (n = 29) of these studies had positive results supporting the effectiveness of mHealth interventions [36]. However, there was still a need for more evidence and higher-quality research in this eld.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

The Effect of a Decision-Support mHealth Application on Maternal and Neonatal Outcomes in Two District Hospitals in Rwanda: Quasi-Experimental Study

Nishimwe

Ibisomi

Nyssen

et al. 2020

Preprint

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Background: Globally, mobile health (mHealth) applications are known for their potential to improve healthcare providers’ access to relevant and reliable health information. Besides, electronic decision support tools, such as the Safe Delivery mHealth Application (SDA), help to reduce clinical errors and to ensure quality care at the point of service delivery. The current study assessed the effects of the SDA on basic emergency obstetric and newborn care (BEmONC) outcomes for the most frequent complications in Rwanda; post-partum haemorrhage (PPH) and newborn asphyxia and its complications.Methods: The study adopted a quasi-experimental design. A pre-intervention record review of the BEmONC outcomes: Apgar score and PPH progressions, was conducted. The intervention took place in two district hospitals in Rwanda and entails the implementation of the SDA for six months. Six months’ post-intervention, the effect of the SDA on BEmONC outcomes was evaluated. The study included 327 participants (114 cases of PPH and 213 cases of neonatal complications). The analysis compared the outcome variables between the baseline and the endline data. Fisher’s exact test was used to compare the proportions and test between-group differences and significance level set at p<0.05. Results: Unstable newborn outcome following neonatal resuscitation was recorded in 61.90% and 27.59% newborns cases at baseline and endline respectively, P-value = 0.000. Unstable maternal outcome following PPH management was recorded in 19.40 % and 6.38% maternal cases at baseline and endline respectively, P-value = 0.048. There was a significant association between the SDA intervention and newborns’ and maternal’ outcomes following neonatal resuscitation and PPH management, 6 months after baseline.Conclusion: The use of the SDA supported nurses and midwives in the management of PPH and neonatal resuscitation thus improved maternal and neonatal outcomes after 6 months of the SDA intervention.

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“…Systematic reviews support the value of mHealth applications as an effective tool to improve MCH related outcomes as a key step towards achieving the Sustainable Development Goals (SDGs), in particular SDG 3 [7,[10][11][12][13][14][15][16]. mHealth has shown to improve health education, facilitate service utilisation, increase clinic attendance, and promote health-seeking behaviour [12,17].…”

Section: Introductionmentioning

confidence: 99%

Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

Kabongo¹,

Mukumbang²,

N³

et al. 2020

Preprint

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Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.

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Effectiveness and Appropriateness of mHealth Interventions for Maternal and Child Health: Systematic Review

Cited by 142 publications

References 30 publications

Development of a targeted client communication intervention to women using an electronic maternal and child health registry: a qualitative study

Development of a targeted client communication intervention to women using an electronic maternal and child health registry: a qualitative study

The Effect of a Decision-Support mHealth Application on Maternal and Neonatal Outcomes in Two District Hospitals in Rwanda: Quasi-Experimental Study

Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

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