Journal Article

An mHealth SMS intervention on Postpartum Contraceptive Use Among Women and Couples in Kenya: A Randomized Controlled Trial

Drake, Alison L., Osoti, Alfred O., Unger, Jennifer A., Harrington, Elizabeth K., John-Stewart, Grace, Kinuthia, John, Ronen, Keshet, Matemo, Daniel

2019

Overview

Objectives. To assess the effect of 2-way short message service (SMS) with a nurse on postpartum contraceptive use among individual women and couples. Methods. From 2016 to 2017, we conducted a randomized controlled trial at 2 public hospitals in western Kenya. We assigned eligible pregnant women to receive 2-way SMS with a nurse or no SMS, with the option to include male partners. We delivered automated family planning–focused SMS messages weekly until 6 months postpartum. Women and men receiving SMS could interact with nurses via SMS. In intention-to-treat analysis, we compared highly effective contraceptive (HEC) use at 6 months postpartum between groups using the χ 2 test. We used Poisson regression in adjusted analysis. Results. We randomized 260 women to 2-way SMS or control, and we enrolled 103 male partners. At 6 months postpartum, 69.9% women receiving SMS reported HEC use, compared with 57.4% in control (relative risk = 1.22; 95% confidence interval [CI] = 1.01, 1.47; P = .04). In analysis adjusted for baseline demographic differences, the adjusted relative risk for HEC use in the SMS group was 1.26 (95% CI = 1.04, 1.52; P = .02). Conclusions. Two-way SMS with a nurse, including optional male participation, increased postpartum contraceptive use. Trial Registration. ClinicalTrials.gov; identifier: NCT02781714.

• Publisher: American Public Health Association
• Subject: Adult / AJPH Open-Themed Research / Automation / Birth Control / Breastfeeding & lactation / Cellular telephones / Clinical trials / Communication / Confidence intervals / Contraception / Contraception Behavior - statistics & numerical data / Contraceptives / Couples / Demographics / Drug therapy / Education / Enrollments / Family planning / Female / Gender / Gender differences / Gestational age / Global Health / Health surveys / HIV / Hospitals / Hospitals, Public / Human immunodeficiency virus / Humans / Immunization / Intervention / Kenya / Male / Males / Medical personnel / Men / Methods / Nurses / Other Maternal and Infant Health / Participation / Patient Acceptance of Health Care / Poisson density functions / Postpartum / Postpartum Period / Postpartum women / Pregnancy / Public health / Qualitative research / Questionnaires / Randomization / Regression analysis / Risk factors / Risk management / Self Report / Short message service / Statistical analysis / Teenagers / Telemedicine / Telemedicine - methods / Text Messaging / Trust / Women / Womens health / Women’s Health / Young Adult