Mobile phone support to sustain exclusive breastfeeding in the community after hospital delivery and counseling: a quasi-experimental study

Jerin, Iftia; Akter, Monira; Talukder, Khurshid; Talukder, Muhammad Qudrat e Khuda; Rahman, Mohammad Abdur

doi:10.1186/s13006-020-00258-z

Cited by 21 publications

(20 citation statements)

References 37 publications

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“…In a two armed, prospective study of pregnant women through the post-partum phase, Patel and team [ 24 ] showed that women who used mobile phones were 6 times more likely to exclusively breastfeed than than those in the control arm (AOR [95% CI]: 6.3 [4.9–8.0]). Similar results were reported by Jerin et al, [ 25 ] in a population of Bangladeshi women. Additional clinical trials of mothers in Nigeria, China, and Kenya [ 9 ] also support the finding that SMS/cell phone interventions improve EBF rates up to 4 months post-partum.…”

Section: Discussionsupporting

confidence: 91%

Exploring association of mobile phone access with positive health outcomes and behaviors amongst post-partum mothers in rural Malawi

Anto-Ocrah

Latulipe

Mark

et al. 2022

BMC Pregnancy Childbirth

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Background Access to mass media and emerging technologies (e.g., cell phones, the internet, and social media) is a social determinant of health that has been shown to profoundly influence women’s health outcomes. In the African region, where women in rural settings with limited access to care are most vulnerable to maternal mortality and other pregnancy-related morbidities, mobile phone access can be an important and life-saving health determinant. Objective The goal of this study was to examine the association between mobile/cellular phone ownership and health behaviors of post-partum mothers in rural Malawi. Methods In this cross-sectional study, we recruited and consented a convenient sample of 174 post-partum mothers of 4- and 5-month-olds who were attending well-child clinics in Gowa, situated in the rural Ntcheu district of Malawi. Using logistic regression models, we hypothesized that compared to non-cell phone owners, mobile phone ownership will be predictive (greater odds) of antenatal visit frequency, exclusive breastfeeding knowledge and practices, health-seeking behaviors, and involvement in motherhood support groups; and protective (lower odds) of infant illnesses, breastfeeding challenges, and post-partum depressive symptoms. Results Mobile phones were highly prevalent in this rural setting, with 45% (n = 79) of post-partum women indicating they owned at least one cell phone. Cell phone owners tended to have higher levels of education (p < 0.012) and wealth (p < 0.001). Interestingly, mobile phone ownership was only associated with exclusive breastfeeding practices; and phone owners had 75% lower odds of exclusively breastfeeding (adj. OR 0.25; 95% CI: 0.07–0.92, p = 0.038) in multivariable models. Though not statistically significant but clinically meaningful, cell phone ownership was associated with fewer depressive symptoms (adj. OR 0.84; 95% CI: 0.39–1.84, p = 0.67) and more social support (adj. OR 1.14; 95% CI: 0.61–2.13, p = 0.70). Conclusions Digital literacy and internet connectivity are social determinants of health, thus delving deeper into mothers’ digital experiences to identify and ameliorate their unique barriers to full digital access will be crucial to successful implementation of digital interventions to address post-partum challenges for women in hard-to-reach settings such as ours. Such interventions are of even greater relevance as the Covid-19 pandemic has increased the urgency of reaching vulnerable, marginalized populations.

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Section: Discussionsupporting

confidence: 91%

Exploring association of mobile phone access with positive health outcomes and behaviors amongst post-partum mothers in rural Malawi

Anto-Ocrah

Latulipe

Mark

et al. 2022

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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“…It may be difficult to improve EBF practices among poor women who lack formal education, particularly when the majority of births take place in homes and are assisted by skilled/traditional birth attendants (TBA) in Bangladesh [ 50 ]. Nonetheless, social and behavioral change interventions [ 68 ], such as maternal counselling [ 69 ], mobile phone follow-up services [ 70 ], and training TBAs [ 71 ] to improve breastfeeding practices for home births in Bangladesh may be effective. Furthermore, a recent study reported a number of interventions such as education and counselling, maternal and newborn health initiatives, community mobilization, and mass media, delivered across several implementation environments- health facility, community, and home/family, were effective in improving breastfeeding practices including early initiation of breastfeeding and EBF in various South Asian countries [ 72 ].In LMICs, wealthier and educated mothers are also more likely to deliver through a caesarean section as compared to vaginal delivery [ 73 , 74 ].…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic inequalities in early initiation and exclusive breastfeeding practices in Bangladesh: findings from the 2018 demographic and health survey

et al. 2021

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Background Optimal breastfeeding practices including early initiation of breastfeeding and exclusive breastfeeding (EBF) are associated with positive health outcomes. Socioeconomic inequalities in key breastfeeding indicators may play a role in the prevalence of breastfeeding practices. The objective of this study was to examine the socioeconomic inequalities in early initiation of breastfeeding and EBF practices in Bangladesh based on the 2018 Bangladesh Demographic and Health Survey (BDHS). Methods This was a secondary data analysis of the nationally representative 2018 BDHS. Data on 4950 women of reproductive age who had ever given birth and 924 children aged 0–5 months were extracted, for early initiation of breastfeeding and EBF. Early initiation of breastfeeding was determined from children who were put to the breast within the first hour of birth. Exclusive breastfeeding was estimated from children aged 0–5 months who were exclusively breastfed. Results The weighted prevalence of early initiation of breastfeeding and EBF were 60.8% (95% CI; 59.0, 62.6%) and 66.8% (95% CI; 63.1, 70.3%), respectively. The estimated prevalence of early initiation among the poorest, poorer, middle, richer and richest households were 67.8, 66.3, 58.4, 56.3 and 54.4%, respectively. Similarly, early initiation prevalence of 64.4, 65.0, 61.1 and 52.3% were estimated among women with no formal education, primary, secondary and higher education, respectively. The estimated prevalence of EBF among the poorest, poorer, middle, richer and richest households were 63.0, 65.2, 67.7, 66.7 and 69.9%, respectively. Similarly, the estimated EBF prevalence were 62.5, 66.0, 66.3 and 68.9% among women with no formal education, primary, secondary and higher education, respectively. Early initiation of breastfeeding was higher among lower household wealth (Conc. Index = − 0.049; SE = 0.006) and lower educational attainment groups (Conc. Index = − 0.035; SE = 0.006). Conclusions Improving optimal breastfeeding practices in Bangladesh should be given utmost priority. A need to address the socioeconomic inequalities in breastfeeding practices was also identified.

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“…Interventions that extend healthcare and interpersonal support beyond health facilities have also shown promise in South Africa and other LMICs [19,40,41]. MomConnect is one component of a national strategy to increase EBF rates and support new mothers.…”

Section: Healthcare Influencesmentioning

confidence: 99%

Reported infant feeding practices and contextual influences on breastfeeding: qualitative interviews with women registered to MomConnect in three South African provinces

et al. 2020

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Background Global guidelines recommend exclusive breastfeeding (EBF) for the first 6 months of life. South African EBF rates have steadily increased but still only average 32% for infants below 6 months of age. Malnutrition and developmental delays continue to contribute substantially to the morbidity and mortality of South African children. MomConnect, a national mHealth messaging system used to send infant and maternal health messages during and after pregnancy, has a specific focus on improving rates of breastfeeding and has achieved high rates of population coverage. Methods For this qualitative study, we interviewed women who were registered to MomConnect to investigate their breastfeeding and other infant feeding practices, decision-making pre- and post-delivery, and the role of the health system, family members and the wider community in supporting or detracting from breastfeeding intentions. Data were collected from February–March 2018 in South Africa’s KwaZulu-Natal, Free State and Gauteng provinces. Framework analysis was conducted to identify common themes. Results Most women interviewed had breastfed, including HIV-positive women. Even when women had delivered by caesarean section, they had usually been able to initiate breastfeeding a few hours after birth. Understandings of EBF varied in thoroughness and there was some confusion about the best way to cease breastfeeding. Most women felt well-equipped to make infant feeding decisions and to stick to their intentions, but returning to work or school sometimes prevented 6 months of EBF. Advice from the health system (both via clinics and MomConnect) was considered helpful and supportive in encouraging EBF to 6 months, although family influences could thwart these intentions, especially for younger women. Mothers reported a range of breastfeeding information sources that influenced their choices, including social media. Conclusions Efforts to improve EBF rates must include consideration of the social and economic environment surrounding women. Interventions that focus only on improving women’s knowledge are valuable but insufficient on their own. Attention should also be paid to infant behaviors, and how these affect women’s breastfeeding choices. Finally, although there is strong local policy support for EBF, more rigorous implementation of these and other broader changes to create a more enabling structural environment ought to be prioritized.

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Mobile phone support to sustain exclusive breastfeeding in the community after hospital delivery and counseling: a quasi-experimental study

Cited by 21 publications

References 37 publications

Exploring association of mobile phone access with positive health outcomes and behaviors amongst post-partum mothers in rural Malawi

Exploring association of mobile phone access with positive health outcomes and behaviors amongst post-partum mothers in rural Malawi

Socioeconomic inequalities in early initiation and exclusive breastfeeding practices in Bangladesh: findings from the 2018 demographic and health survey

Reported infant feeding practices and contextual influences on breastfeeding: qualitative interviews with women registered to MomConnect in three South African provinces

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