Use of mobile phones for behavior change communication to improve maternal, newborn and child health: a scoping review

Abstract

BackgroundBehavior change communication (BCC) to improve health and caring practices is an integral component of efforts to improve maternal, newborn and child health (MNCH). Mobile phones are widely available in low- and middle-income countries (LMIC), presenting new opportunities for BCC delivery. There is need for delivery science to determine how best to leverage mobile phone technology for BCC to improve MNCH practices.MethodsWe conducted a scoping review of studies and project reports documenting the feasibility, implementation or effectiveness of using mobile phones for BCC delivery related to MNCH in LMIC. Data were extracted and synthesized from three sources: i) systematic search of three electronic databases (PubMed, MedLine, Scopus); ii) grey literature search, including mHealth databases and websites of organizations implementing mHealth projects; iii) consultation with researchers and programme implementers. Records were screened using pre-determined inclusion criteria and those selected were categorized according to their primary intervention delivery approaches. We then performed a descriptive analysis of the evidence related to both effectiveness and implementation for each delivery approach.ResultsThe systematic literature search identified 1374 unique records, 64 of which met inclusion criteria. The grey literature search added 32 records for a total of 96 papers in the scoping review. Content analysis of the search results identified four BCC delivery approaches: direct messaging, voice counseling, job aid applications and interactive media. Evidence for the effectiveness of these approaches is growing but remains limited for many MNCH outcomes. The four approaches differ in key implementation elements, including frequency, length and complexity of communication, and potential for personalization. These elements influence resource allocation and are likely to impact effectiveness for BCC targeting complex, habitual MNCH practices.ConclusionsThis scoping review contributes to the evidence-base on the opportunities and limitations of using mobile phones for BCC delivery aiming to improve MNCH practices. The incorporation of mobile phone technology in BCC interventions should be guided by formative research to match both the content and delivery approach to the local context. We recommend five areas for further research, including both effectiveness and implementation studies on specific delivery approaches.

Mobile consulting (mConsulting) as an option for accessing healthcare services for communities in remote rural areas and urban slums in low- and middle- income countries: A mixed methods study

“…This timeframe coincides with the emergence of WHO guidance on digital interventions for health systems 11 and recognises the rapidly changing nature of digital technology. Building on our previous reviews of two-way digital clinical communication [12][13][14][15][16][17][18] , with added parameters for LMIC contexts, we identified seven systematic reviews [19][20][21][22][23][24][25] and five empirical studies [26][27][28][29][30] involving mConsulting in LMICs, as per our definition 7 (see, Appendix 1, for our search strategy).…”

“…The seven reviews included studies from a range of LMIC countries [19][20][21][22][23][24][25] , while the empirical studies were from Ghana 30 , Kenya 28 , Bangladesh 26,29 and India 27 . mConsulting was used in maternal, newborn and child health care in two reviews 24,25 and four studies [27][28][29][30] .…”

“…The seven reviews included studies from a range of LMIC countries [19][20][21][22][23][24][25] , while the empirical studies were from Ghana 30 , Kenya 28 , Bangladesh 26,29 and India 27 . mConsulting was used in maternal, newborn and child health care in two reviews 24,25 and four studies [27][28][29][30] . Other conditions included chronic care (n=3) 22,23,26 for non-communicable disease, diabetes, tuberculosis, HIV and cancer; general health (n=2) 20,21 ; mental health for mothers living with HIV (n=1) 27 ; and adolescent health (n=1) 19 .…”

“…Dol (2018) found that mConsulting, during the perinatal period, increased mothers' attendance of antenatal and postnatal services 24 . Mobile communication was seen to improve maternal, newborn and child health across many LMICs 25 . Mobile consultation with providers was found to contribute to improved treatment adherence and blood glucose self-testing for diabetic patients, alongside increased patient-provider communication more generally 23 .…”

“…Following the screening of titles and abstracts, we included 36 reviews and 28 empirical studies for full text review. After reviewing the full papers, seven reviews [19][20][21][22][23][24][25] and five empirical studies [26][27][28][29][30] met the inclusion criteria. Appendix 2.…”