Access to and Use of Mobile Phone by Postpartum, Married Women in Punjab, India: Secondary Analysis of mHealth Intervention Pilot Data (Preprint)

Abstract

BACKGROUND As mobile phone uptake in India continues to grow, there is continued interest in mobile platform-based interventions for health education among other topics. Existing studies demonstrate a significant gender gap in mobile phone access, and suggest women’s access to mobile phones is constrained by economic and diverse social barriers. Pregnancy and postpartum care is one of many targets for mobile health (mHealth) interventions which particularly rely on women’s access to and facility with mobile phone use. OBJECTIVE This paper describes dynamics and patterns of women’s mobile phone access and use among both phone owners and non-owners, including potential barriers to mHealth participation. METHODS Mixed-methods data were obtained from two different surveys (n=102 and n=29), two sets of in-depth interviews (n=20 and 29), and weekly data collection obtained in preparation for or within the pilot of an mHealth postpartum care intervention in rural Punjab in July 2020-February 2021. RESULTS A majority of women owned their own phone, though about half (52%) of phone owners still reported sharing their phone with other family members. Sharing a phone with female family members typically allowed for better access than sharing with male family members. Some households have strict preferences against daughters-in-law having phones, or otherwise significantly restrict or control women’s phone access. Others reported concerns about phone use-related health hazards during pregnancy or postpartum for mother and infant. CONCLUSIONS These findings suggest significant variability and nuance to what is meant by women’s phone ownership and access given the numerous additional constraints on their use of phones, particularly during pregnancy and postpartum. Future research and mHealth interventions should probe these domains to better understand these dynamics governing women’s access, use, and fluency with mobile phones to optimally design mHealth interventions. mHealth, mobile health, digital health, India, pregnancy, pregnant women, postpartum, postpartum care INTERNATIONAL REGISTERED REPORT RR2-10.2196/preprints.34087