A Mobile Education and Social Support Group Intervention for Improving Postpartum Health in Northern India: Development and Usability Study

Abstract

Background Structural and cultural barriers limit Indian women’s access to adequate postnatal care and support despite their importance for maternal and neonatal health. Targeted postnatal education and support through a mobile health intervention may improve postnatal recovery, neonatal care practices, nutritional status, knowledge and care seeking, and mental health. Objective We sought to understand the feasibility and acceptability of our first pilot phase, a flexible 6-week postnatal mobile health intervention delivered to 3 groups of women in Punjab, India, and adapt our intervention for our next pilot phase, which will formally assess intervention feasibility, acceptability, and preliminary efficacy. Methods Our intervention prototype was designed to deliver culturally tailored educational programming via a provider-moderated, voice- and text-based group approach to connect new mothers with a social support group of other new mothers, increase their health-related communication with providers, and refer them to care needed. We targeted deployment using feature phones to include participants from diverse socioeconomic groups. We held moderated group calls weekly, disseminated educational audios, and created SMS text messaging groups. We varied content delivery, group discussion participation, and chat moderation. Three groups of postpartum women from Punjab were recruited for the pilot through community health workers. Sociodemographic data were collected at baseline. Intervention feasibility and acceptability were assessed through weekly participant check-ins (N=29), weekly moderator reports, structured end-line in-depth interviews among a subgroup of participants (15/29, 52%), and back-end technology data. Results The participants were aged 24 to 28 years and 1 to 3 months postpartum. Of the 29 participants, 17 (59%) had their own phones. Half of the participants (14/29, 48%) attended ≥3 of the 6 calls; the main barriers were childcare and household responsibilities and network or phone issues. Most participants were very satisfied with the intervention (16/19, 84%) and found the educational content (20/20, 100%) and group discussions (17/20, 85%) very useful. The participants used the SMS text messaging chat, particularly when facilitator-moderated. Sustaining participation and fostering group interactions was limited by technological and sociocultural challenges. Conclusions The intervention was considered generally feasible and acceptable, and protocol adjustments were identified to improve intervention delivery and engagement. To address technological issues, we engaged a cloud-based service provider for group calls and an interactive voice response service provider for educational recordings and developed a smartphone app for the participants. We seek to overcome sociocultural challenges through new strategies for increasing group engagement, including targeting midlevel female community health care providers as moderators. Our second pilot will assess intervention feasibility, acceptability, and preliminary effectiveness at 6 months. Ultimately, we seek to support the health and well-being of postpartum women and their infants in South Asia and beyond through the development of efficient, acceptable, and effective intervention strategies.

Uptake, Engagement and Acceptance, Barriers and Facilitators of a Text Messaging Intervention for Postnatal Care of Mother and Child in India—A Mixed Methods Feasibility Study

“…Studies on testing mHealth interventions for postnatal care in India is limited [ 34 , 35 ]. And our study results indicate that new mothers who used the service found that the intervention to be informative, timely and empowering.…”

“…On the other hand, in India, studies on testing mHealth interventions for postnatal care are limited [ 34 , 35 ]. To address the above issues, an innovative solution to provide ongoing follow-up service to new mothers at discharge was designed.…”

Mobile communication on post-partum minor health alignments’ recovery and family planning seeking care among primiparous

“…Moreover, it is a critical component of the full continuum of perinatal care. Mobile phone-based health approaches (mobile health communication) offer innovative opportunities to overcome logistical barriers to postnatal care access and positively affected maternal and neonatal health outcomes (El Ayadi et al, 2022).…”

“…It was developed by the researchers after reviewing literatures (El Ayadi et al, 2022) to assess woman's satisfaction regarding Mobil health teaching and traditional teaching. It consists of three points Likert Scale, start from score one for disagree, score two for undecided, score three for agree.…”

The Effectiveness Of The Use Of Decision-Making Tools And WHO Wheel Criteria In the Selection Of Contraception For Post Partum Mother

“…The results of the data analysis test using the Mann-Whitney test showed a significance value of 0.002 <0.05, which can be concluded that Ho is rejected and Ha is accepted, that is, there is no difference. There is a significant difference between the effectiveness of ABPK and WHO Wheel Criteria in selecting contraception for postpartum women (El Ayadi et al, 2022;Festin, 2020;Saleem et al, 2022).…”