Effectiveness of an SMS-based maternal mHealth intervention to improve clinical outcomes of HIV-positive pregnant women

Abstract

We conducted a retrospective study to investigate the effectiveness of an mHealth messaging intervention aiming to improve maternal health and HIV outcomes. Maternal health SMSs were sent to 235 HIV-infected pregnant women twice per week in pregnancy and continued until the infant's first birthday. The messages were timed to the stage of the pregnancy/infant age and covered maternal health and HIV-support information. Outcomes, measured as antenatal care (ANC) visits, birth outcomes and infant HIV testing, were compared to a control group of 586 HIV-infected pregnant women who received no SMS intervention. Results showed that intervention participants attended more ANC visits (5.16 vs. 3.95, p < 0.01) and were more likely to attend at least the recommended four ANC visits (relative risk (RR): 1.41, 95% confidence interval (CI): 1.15-1.72). Birth outcomes of intervention participants improved as they had an increased chance of a normal vaginal delivery (RR: 1.10, 95% CI: 1.02-1.19) and a lower risk of delivering a low-birth weight infant (<2500 g) (RR: 0.14, 95% CI: 0.02-1.07). In the intervention group, there was a trend towards higher attendance to infant polymerase chain reaction (PCR) testing within six weeks after birth (81.3% vs. 75.4%, p = 0.06) and a lower mean infant age in weeks at HIV PCR testing (9.5 weeks vs. 11.1 weeks, p = 0.14). These results add to the growing evidence that mHealth interventions can have a positive impact on health outcomes and should be scaled nationally following comprehensive evaluation.

Effects of an mHealth voice message service (mMitra) on maternal health knowledge and practices of low-income women in India: findings from a pseudo-randomized controlled trial

“…There was a trend towards registering their pregnancy in the first trimester, and there were also slightly more women who completed 3 or more ANC visits. These findings are in line with previous reports where mobile phone text-based messages increased attendance of ANC visits in low and middle-income countries [13,14,15,16,17], and there are recent studies that report that mobile phone text-based interventions improved skilled birth attendance and uptake of facility-based maternal care [1,13,15].…”

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

“…Uptake and outcomes of mHealth for pregnant women and mothers Table 4 presents the relevant themes used to develop the ICAMO model for pregnant women and mothers while Figure 4 presents a model illustrating how and why various aspects of mHealth interventions work for pregnant women and mothers. Table 4: Thematic representation of the element of pregnant women and mothers mHealth interventions also provide a communication platform for health education (I) for pregnant women and mothers [4,18,44,46,47,49,50,53,54,[58][59][60][61][62][63][64][65]. Health education is in uenced by sociocultural norms, technical aspects of mobile phone services, political clout, socioeconomic status, and community buy-in (C).…”

Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation (Preprint)

“…SMS interventions have been evaluated across sub-Saharan Africa for their capacity to improve medication adherence [26], support the dissemination of lab results [27], and reduce missed clinic visits [28]. However, with few exceptions [29], the existing literature does not address how often SMS are received, understood, and retained by participants.…”

“…Median age among adult participants was 27 years of age (interquartile range (IQR) [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Step 2: SMS Received…”