Journal Article

The Effects of a Locally Developed mHealth Intervention on Delivery and Postnatal Care Utilization; A Prospective Controlled Evaluation among Health Centres in Ethiopia

Tekie, Michael, Fantahun, Mesganaw, Spigt, Mark, Shiferaw, Solomon, Abdullah, Muna, Dinant, Geert-Jan

2016

Overview

Although there are studies showing that mobile phone solutions can improve health service delivery outcomes in the developed world, there is little empirical evidence that demonstrates the impact of mHealth interventions on key maternal health outcomes in low income settings. A non-randomized controlled study was conducted in the Amhara region, Ethiopia in 10 health facilities (5 intervention, 5 control) together serving around 250,000 people. Health workers in the intervention group received an android phone (3 phones per facility) loaded with an application that sends reminders for scheduled visits during antenatal care (ANC), delivery and postnatal care (PNC), and educational messages on dangers signs and common complaints during pregnancy. The intervention was developed at Addis Ababa University in Ethiopia. Primary outcomes were the percentage of women who had at least 4 ANC visits, institutional delivery and PNC visits at the health center after 12 months of implementation of the intervention. Overall 933 and 1037 women were included in the cross-sectional surveys at baseline and at follow-up respectively. In addition, the medical records of 1224 women who had at least one antenatal care visit were followed in the longitudinal study. Women who had their ANC visit in the intervention health centers were significantly more likely to deliver their baby in the same health center compared to the control group (43.1% versus 28.4%; Adjusted Odds Ratio (AOR): 1.98 (95%CI 1.53-2.55)). A significantly higher percentage of women who had ANC in the intervention group had PNC in the same health center compared to the control health centers (41.2% versus 21.1%: AOR: 2.77 (95%CI 2.12-3.61)). Our findings demonstrated that a locally customized mHealth application during ANC can significantly improve delivery and postnatal care service utilization possibly through positively influencing the behavior of health workers and their clients.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adult / Analysis / Cellular telephones / Colleges & universities / Control methods / Correlation analysis / Cross-Sectional Studies / Delivery scheduling / Delivery, Obstetric - methods / Delivery, Obstetric - statistics & numerical data / Engineering and Technology / Ethiopia / Female / Follow-Up Studies / Health aspects / Health care facilities / Health centres / Health facilities / Health Personnel - standards / Health Personnel - statistics & numerical data / Humans / Intervention / Longitudinal studies / Maternal Health Services - statistics & numerical data / Medical personnel / Medical records / Medicine and Health Sciences / Methods / Methyltestosterone / Middle Aged / Non-Randomized Controlled Trials as Topic / Nurses - standards / Nurses - statistics & numerical data / Patient care / Postnatal care / Postnatal Care - methods / Postnatal Care - statistics & numerical data / Pregnancy / Prenatal Care - methods / Prenatal Care - statistics & numerical data / Prospective Studies / Rural Population - statistics & numerical data / Smartphones / Technology application / Telemedicine / Text messaging / Time Factors / Urban Population - statistics & numerical data / Wireless telephones / Womens health / Workers / Young Adult