Effects of postpartum mobile phone-based education on maternal and infant health in Ecuador

Abstract

Objective To evaluate the effects of a mobile phone-based intervention on postnatal maternal health behavior and maternal and infant health in a middle-income country. Methods A prospective evaluation enrolled consecutive postpartum women at two public hospitals in Quito, Ecuador, between June and August 2012. Inclusion criteria were live birth, no neonatal intensive care admission, and Spanish speaking. Intervention and control groups were assigned via random number generation. The intervention included a telephone-delivered educational session and phone/text access to a nurse for 30 days after delivery. Maternal and infant health indicators were recorded at delivery and 3 months after delivery via chart review and written/telephone-administered survey. Results Overall, 102 women were assigned to the intervention group and 76 to the control group. At 3 months, intervention participants were more likely to attend the infant’s postnatal check-up (P = 0.022) and to breastfeed exclusively (P = 0.005), and less likely to feed formula (P = 0.016). They used more effective forms of contraception (more implants P = 0.023; fewer condoms P = 0.036) and reported fewer infant illnesses (P = 0.010). There were no differences in maternal acute illness or check-up attendance. Conclusion Mobile phone-based postnatal patient education is a promising strategy for improving breastfeeding, contraceptive use, and infant health in low-resource settings; different strategies are needed to influence post-partum maternal health behavior.

Effectiveness of mHealth Interventions for Improving Contraceptive Use in Low- and Middle-Income Countries: A Systematic Review

“…Some were conducted in urban 18 or peri-urban and rural areas, 22 while others were conducted in a hospital or clinic setting 19,[23][24][25] ; settings for 2 studies were not specified. 20,21 The studies also varied by types of participants: postpartum mothers, 19,23,25 postabortion women, 22,24 young people, 20,21 and general public. 18 Outcomes for 6 of All 8 studies were parallel-group RCTs with 1:1 allocation, but they varied in terms of setting, participants, outcomes, and theory.…”

“…17 Several interventions have been implemented to assess whether mHealth technologies could be used to help reduce unmet contraceptive needs in LMICs by attempting to increase the uptake of modern contraceptive methods. [18][19][20][21][22][23][24][25] Three published reviews [26][27][28] explored the effectiveness of mHealth interventions for different contraceptive outcomes. Smith et al 28 assessed the effect of interventions delivered via mobile phone for improving contraceptive use in 5 randomized controlled trials (RCTs) conducted in the United States, Cambodia, and Israel.…”

Feasibility, Acceptability and Usage Patterns of a 24-Hour Mobile Phone Helpline Service for Women Discharged from a Mother-Baby Psychiatry Unit (MBU) in India

“…17 While helpline services have been reported as being useful among postpartum women in the community who have concerns about breastfeeding, a similar study has not been done among those with mental health problems, at least in a LAMIC setting. 18 While designing a service model, we need to consider the limiting factors for mobile phone based interventions in a low resource and culturally diverse country like India. Cost of the phone service, language and literacy barriers (with the patient and the care provider sometimes speaking different languages), lack of electricity supply, data security, and privacy issues are potential barriers and limiting factors for mobile-technology-based mental health services in these countries.…”

Attempts to strengthen maternal functioning in the postpartum period: A literature review

“…It was emphasized that tele message and counseling increased women's walking and physical activity frequency. One another study show that mobile phone-based postnatal patient education is a promising strategy for improving breastfeeding, contraceptive use, and infant health in low-resource settings; different strategies are needed to influence postpartum maternal health behavior (Maslowsky et al, 2016).…”