Effectiveness of a mobile health intervention on infant and young child feeding among children ≤ 24 months of age in rural Islamabad over six months duration

Abstract

Background: Childhood development is highly influenced by feeding practices at infancy and young age of the children. Unfortunately, according to the National Nutrition Survey (2011), the prevalence of exclusive breastfeeding in Pakistan was 21% at four months, and 13% at six months of age with 51.3% of mothers initiating semisolid foods to their children at the recommended 6-8 months of age. Pakistan Demographic & Health Survey (PDHS 2018) however; indicates that only 48% of infants are exclusively breastfed which has been improved from 38% as reported in the past five years but still more improvement is envisaged. Methods: A quasi-experimental study design was employed for this post-intervention survey assessing effectiveness of mobile health (mhealth) regarding infant & young child feeding (IYCF) among pregnant and lactating mothers in Tarlai, Islamabad from May to June 2018. A total of 135 mothers who were earlier included in the intervention phase were recruited after obtaining verbal & written consent. The data was entered in EpiData (3.1) and analyzed in SPSS version 21. Results: The mean age of these pregnant and lactating mothers was 30.5 years ± 4.5 SD with the majority of mothers in the age group of 25 to 29 years. After intervention, the overall knowledge of mothers regarding IYCF nutrition was raised among 94 mothers (69.6%) as compared to 74 (54.8%) mothers prior to the intervention. Overall attitude regarding IYCF was found to be positive among 86 (63.7%) of the mothers, whereas 88 (65.2%) of the mothers had good IYCF related practices. Conclusion: Our post-intervention survey signifies the effectiveness of mhealth in raising knowledge, attitude, and practices of mothers regarding IYCF in rural Islamabad. However, implementation of mhealth in masses requires future research specifically to address cost-effectiveness of such interventions in maternal & child health programmes.

The promise of telemedicine in Pakistan: A systematic review

“…Out of 11, eight studies were conducted in the urban region, 13 , 14 , 15 , 16 , 18 , 20 , 21 , 23 whereas three studies were conducted in the rural areas of Pakistan. 17 , 19 , 22 Most of the studies were of the cross‐sectional type, 13 , 14 , 17 , 18 , 21 , 23 followed in the descending order by randomized control trials, 15 , 16 , 20 quasi‐experimental design, 19 and qualitative interview analyses. 22 …”

“…An easy‐to‐use, smartphone android‐based audiovisual application was developed for lady health workers who were then qualified and monitored to use it in the frame of the Infant and Young Child Feeding (IYCF) program. 19 The use of these approaches enables us to understand the use of mHealth in enhancing the knowledge, practices, and attitudes of IYCF mothers in rural areas of Islamabad. Another work on childhood immunization in rural districts of Pakistan provided a qualitative experience on the utilization of digital health technologies among medical staff.…”

“…A study highlighted the efficiency of mHealth on young children (≤24 months). An easy‐to‐use, smartphone android‐based audiovisual application was developed for lady health workers who were then qualified and monitored to use it in the frame of the Infant and Young Child Feeding (IYCF) program 19 . The use of these approaches enables us to understand the use of mHealth in enhancing the knowledge, practices, and attitudes of IYCF mothers in rural areas of Islamabad.…”

“…We have identified only three studies conducted in the rural region of Pakistan, suggesting that both patients and caregivers were satisfied with telehealth due to a variety of reasons. 17 , 19 , 25 Specifically, attending an appointment in one's local community via telehealth compensated for the hassle of commuting long distances to an urban center for the same appointment. 17 A few studies have used geospatial monitoring along with mHealth for the need for immunization and the significance of completing a sequence of vaccines.…”

“…Unfortunately, only a few studies have analyzed the satisfaction of patients and caregivers with telehealth. We have identified only three studies conducted in the rural region of Pakistan, suggesting that both patients and caregivers were satisfied with telehealth due to a variety of reasons 17,19,25 . Specifically, attending an appointment in one's local community via telehealth compensated for the hassle of commuting long distances to an urban center for the same appointment 17 .…”