Evaluating the effect of maternal mHealth text messages on uptake of maternal and child health care services in South Africa: a multicentre cohort intervention study

Abstract

Background There are high expectations that mobile health (mHealth) strategies will increase uptake of health care services, especially in resource strained settings. Our study aimed to evaluate effects of an mHealth intervention on uptake of maternal health services. Methods This was an intervention cohort study conducted at six public antenatal and postnatal care clinics in inner-city Johannesburg, South Africa. The intervention consisted of twice-weekly informative and pregnancy stage-based maternal health information text messages sent to women during pregnancy until their child was one year of age. The intervention arm of 87 mother-infant pairs was compared to a control arm of 90 pairs. Univariate and multivariate analyses were used to compare the probability of the outcome between the two groups. Results Intervention participants had higher odds of attending all government-recommended antenatal and postnatal visits, all recommended first year vaccinations (OR: 3.2, 95% CI 1.63–6.31) and had higher odds of attending at least the recommended four antenatal visits (OR: 3.21, 95% CI 1.73–5.98). Conclusion We show an improvement in achieving complete maternal-infant continuum of care, providing evidence of a positive impact of informative maternal mHealth messages sent to pregnant women and new mothers. Trial registration ISRCTN, ISRCTN41772986. Registered 13 February 2019—Retrospectively registered, https://www.isrctn.com/ISRCTN41772986

Mobile Phone Automated Messaging Service’s and the Fulfilment of Planned Clinical Appointments: Lessons from an Ebola Clinical Study in Kambia District, Sierra Leone

“…Even those that missed appointments at some point for some reasons endeavored to make it to the clinic a few days after the appointment date and no one missed because of sickness. This finding is in agreement with a study on evidence of the role of mobile messaging in maternal and child health that found a statistically significant increase of over 10% in the proportion of women receiving at least four antenatal care visits, 50% less likeliness to fail to attend postnatal visits and statistically significant increase (from 34.5% to 44.2%) in the proportion of children receiving on-time vaccination after implementation of a mobile application for automated text message appointment reminders [14].…”

Descriptive analysis of routine childhood immunisation timeliness in the Western Cape, South Africa

“…These reminder systems will particularly serve to remind those caregivers who delay uptake of vaccines because of busy work schedules. A recent South African multi-centre study reported the use of mobile reminders to effectively increase uptake of recommend maternal and childhood immunisations [46] . It is worth noting that in LMICs, mobile reminders have been reported to be effective only when caregivers receive two or more reminders [47] .…”

Short message service (SMS) reminders for childhood immunisation in low-income and middle-income countries: a systematic review and meta-analysis

“…57 A total of 32 712 infants (17 135 in intervention groups and 15 577 in control groups) were included in this review. Studies were undertaken in 11 different countries, including Nigeria (n=5), 49 52 57 61 62 Guatemala (n=3), 47 59 60 Kenya (n=2), 48 63 and one each in Bangladesh, 55 Burkina Faso, 53 Cote D’ivoire, 58 India, 54 Pakistan, 50 South Africa, 56 Vietnam 51 and Zimbabwe. 46 Included studies reported 19 different interventions: 9 in urban settings, 7 in rural settings and 3 were in mixed settings.…”

“…Most studies (n=4689) were excluded. After eligibility and critical appraisal of the full texts of 39 records, 18 studies met the inclusion criteria for data extraction, qualitative synthesis and meta-analysis, [46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] while 21 studies were excluded for the following reasons: intervention was not SMS reminder (n=9), [64][65][66][67][68][69][70][71][72] study setting was not an LMIC (n=2), 73 74 conference abstract (n=2), 75 76 literature reviews (n=2), 77 78 could not extract data on specific effect of SMS reminder (n=2), 79 80 observational case-control study (n=1), 81 no comparator/control arm (n=1), 82 control arm not usual care (n=1) 83 and outcome was not DPT-3, Penta-3 or overall immunisation (n=1). 84 Characteristics of included studies Table 1 summarises the main characteristics of the 18 studies included in the analysis.…”