Women’s Perceptions of Using Mobile Phones for Maternal and Child Health Support in Afghanistan: Cross-Sectional Survey

Yamin, Fazal; Kaewkungwal, Jaranit; Singhasivanon, Pratap; Lawpoolsri, Saranath

doi:10.2196/mhealth.9504

Cited by 21 publications

(16 citation statements)

References 12 publications

(13 reference statements)

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“…Our results indicate that the adapted MAMA program was feasible and acceptable to implement in Afghanistan. Consistent with other evidence from Afghanistan, most participants preferred to receive voice calls rather than SMS text messages [ 16 ]. Nearly all participants continued to receive messages 6 to 8 months after enrollment and reported that they benefitted from the program.…”

Section: Discussionsupporting

confidence: 83%

“…Mobile phone ownership is higher among men compared to women; however, a 2012 cross-sectional survey found that 80% of women reported routinely using a mobile phone [ 15 ], and evidence suggests that their phone use is increasing. A 2015 cross-sectional survey in Nangarhar province found that 92% of women routinely used mobile phones [ 16 ]. Mobile phone–based programming for various health education purposes has been documented globally with mixed success; however, to date, there is no literature on the use of such programs in Afghanistan.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and Acceptability of an Adapted Mobile Phone Message Program and Changes in Maternal and Newborn Health Knowledge in Four Provinces of Afghanistan: Single-Group Pre-Post Assessment Study

Lebrun¹,

Dulli²,

Alami³

et al. 2020

JMIR Mhealth Uhealth

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Background Mobile phone apps for health promotion have expanded in many low- and middle-income countries. Afghanistan, with high maternal and newborn morbidity and mortality rates, a fragile health infrastructure, and high levels of mobile phone ownership, is an ideal setting to examine the utility of such programs. We adapted messages of the Mobile Alliance for Maternal Action (MAMA) program, which was designed to promote healthy behaviors during pregnancy and a newborn’s first year of life, to the Afghan context. We then piloted and assessed the program in the provinces of Kabul, Herat, Kandahar, and Balkh. Objective The aim of this study was to assess the feasibility and acceptability of the MAMA pilot program, and to examine changes in reported maternal, newborn, and child health (MNCH) knowledge and attitudes among participants from baseline to follow up. Methods We conducted a single-group study with data collected within 10 weeks of enrollment, and data collection was repeated approximately 6 months later. Data were collected through face-to-face interviews using structured questionnaires. Eligible participants included pregnant women who had registered to receive fully automated mobile health messages and their husbands. Assessment questionnaires queried sociodemographic details; knowledge, attitudes, and health care-seeking practices; and intervention experience and acceptability at follow up. The number of messages received by a given phone number was extracted from the program database. We descriptively analyzed the feasibility and acceptability data and compared the change in MNCH knowledge between baseline and follow-up measures using the McNemar Chi square test. Results Overall, 895 women were enrolled in the MAMA program. Data from 453/625 women (72.5% of the pretest sample) who received voice (n=302) or text (n=151) messages, and 276/427 men (64.6% of the pretest sample) who received voice (n=185) or text (n=91) messages contributing data at both time points were analyzed. At follow up, 699/729 (95.9%) participants were still enrolled in the MAMA program; voice message and SMS text messaging subscribers received 43 and 69 messages on average over the 6-month period, respectively. Participants who were voice message subscribers and female participants more commonly reported missing messages compared with the text message subscribers and men; predominant reasons for missed messages were the subscribers being busy with chores or not having their shared phone with them. Over 90% of men and women reported experiencing benefits from the program, mainly increased knowledge, and 226/453 (49.9%) of the female participants reported referring someone else to the program. Most of the participants (377/453, 83.2% women and 258/276, 93.5% men) believed it was beneficial to include husbands in the program. Joint decision making regarding maternal and child health care increased overall. The proportions of par...

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Feasibility and Acceptability of an Adapted Mobile Phone Message Program and Changes in Maternal and Newborn Health Knowledge in Four Provinces of Afghanistan: Single-Group Pre-Post Assessment Study

Lebrun¹,

Dulli²,

Alami³

et al. 2020

JMIR Mhealth Uhealth

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“…Uptake and outcomes of mHealth for pregnant women and mothers Table 4 presents the relevant themes used to develop the ICAMO model for pregnant women and mothers while Figure 4 presents a model illustrating how and why various aspects of mHealth interventions work for pregnant women and mothers. Table 4: Thematic representation of the element of pregnant women and mothers mHealth interventions also provide a communication platform for health education (I) for pregnant women and mothers [4,18,44,46,47,49,50,53,54,[58][59][60][61][62][63][64][65]. Health education is in uenced by sociocultural norms, technical aspects of mobile phone services, political clout, socioeconomic status, and community buy-in (C).…”

Section: Resultsmentioning

confidence: 99%

Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

Kabongo¹,

Mukumbang²,

N³

et al. 2020

Preprint

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Abstract Introduction Despite the growing global application of mobile health (mHealth) technology in maternal and child health, the contextual factors and mechanisms by which interventional outcomes are generated have not been subjected to extensive review. In this study, we sought to identify context, mechanisms and outcome elements from implementation and evaluation studies of mHealth interventions to formulate theories or models explicating how mHealth interventions work (or not) both for health care providers and for pregnant women and new mothers.Method An electronic search of six online databases (Medline, Pubmed, Google Scholar, Scopus, Academic Search Premier and Health Systems Evidence) was performed. Using appropriate MeSH terms and selection procedure, 32 articles were considered for analysis. A theory-driven approach, narrative synthesis, was applied to synthesise the data. Thematic content analysis was used to delineate the elements of the intervention, including its context, actors, mechanism and outcomes. Retroduction was applied to link these elements using a realist evaluation heuristic to form generative theories.Results Mechanisms that promote the implementation of mHealth by community health workers/health care providers include motivation, perceived skill and knowledge improvement, improved self-efficacy, improved confidence, improved relationship between community health workers and clients, perceived support of community health workers, perceived ease of use and usefulness of mHealth, For pregnant women and new mothers, mechanisms that trigger the uptake of mHealth and use of maternal and child health services included: perceived service satisfaction, perceived knowledge acquisition, support and confidence, improved self-efficacy, encouragement, empowerment and motivation. Information overload was identified as a potential negative mechanism for the uptake of maternal and child health services.Conclusion The models developed in this study provide a detailed understanding of the implementation and uptake of mHealth interventions and how they improve maternal and child health services in low and middle income countries. These models provide a foundation for the ‘white box’ or theory-driven evaluation of mHealth intervention and can improve the rollout and implementation where required.

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“…The same study also revealed that automated voice call was the most preferred method for sending health messages. More than 90% of women are willing to receive reminders for their children's vaccination and antenatal care [67]. Evidence also show that telemedicine reduced travel restrictions, treatment expenses and apprehension regarding sexual and reproductive health.…”

Section: Risk Of Bias Across Studiesmentioning

confidence: 99%

Evidence on access to health care information by women of reproductive age in Low-and-Middle-Income Countries: Scoping Review

Shatilwe

Kuupiel

Mashamba-Thompson

2020

Preprint

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Background Majority of women of reproductive age in Low and Middle Income Countries (LMICs) are not able to access health services due to different factors. The main objective of this scoping review is to map the literature on access to healthcare information by women of reproductive age in LMICs. Methods The literature search was conducted through the following databases: Scholar, Science Direct, PubMed, EBSCOhost (Academic search complete, CINAHL with full text, MEDLINE with full text, MEDLINE, and PsycINFO), Emerald, Embase, published and peer reviewed journals, organizational projects, reference list, grey literature as well as reports related to this objective were included in the study. Studies reporting evidence on interventions aimed at enabling access to health care information in LMICs published during the period 2004 to until recent, were eligible for inclusion. Identified key words were used to search articles from the databases. Following title screening, two reviewers independently reviewed the abstracts and full articles. Inclusion and exclusion criteria was considered to guide the screening. Results A total of 451 900 articles were identified from all the databases searched. Of these, four articles meet inclusion criteria after full article screening and were included for data extraction. The included articles were conducted in the following countries: Eastern Uganda, Gauteng, South Africa, Myanmar and Nepal. The themes that emerged from our study are as follows: accessibility, financial accessibility/affordability, connectivity and challenges. This study demonstrated that, there are minimal interventions that enable women of reproductive age to access healthcare information in terms of accessibility, financial accessibility and connectivity. The study further revealed that with the minimal strategies tried, such as telemedicine and text messages, a large population of women could be reached and this strategies are less cost. Conclusion The findings of the study revealed poor access and utilization of maternal healthcare information by women of reproductive age. We therefore recommend primary studies in other LMICs to determine the accessibility, financial accessibility, connectivity and challenges faced by women of reproductive age in LMICs to reduce maternal and neonatal mortality rate and to achieve the Sustainable Development Goal 3.

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Women’s Perceptions of Using Mobile Phones for Maternal and Child Health Support in Afghanistan: Cross-Sectional Survey

Cited by 21 publications

References 12 publications

Feasibility and Acceptability of an Adapted Mobile Phone Message Program and Changes in Maternal and Newborn Health Knowledge in Four Provinces of Afghanistan: Single-Group Pre-Post Assessment Study

Feasibility and Acceptability of an Adapted Mobile Phone Message Program and Changes in Maternal and Newborn Health Knowledge in Four Provinces of Afghanistan: Single-Group Pre-Post Assessment Study

Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: A theory-driven scoping review

Evidence on access to health care information by women of reproductive age in Low-and-Middle-Income Countries: Scoping Review

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