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Background: The global proliferation of mobile technology has generated a new tool to address public health challenges and shift the paradigm of health care access and delivery. The World Vision Organization currently has a Mobile Health Division that has developed Mobile Technologies for Health (mHealth). This platform bridges the practice of medicine with the practice of public health, through mobile technologies. This new field has emerged as a viable source to communicate health needs and collect community health data. It has been used to enhance healthcare information delivery to community health workers (CHW), researchers, physicians and patients, in real-time—and in the midst of rural, geographically-primitive areas.
Program background: Improving the well-being of mothers, infants, and children is an important public health goal across the globe. Enhancing health behavior during pregnancy can determine the wellbeing of the next generation and can help predict future public health challenges for families, communities, and the health care system. World Vision’s goal for this project was to examine the value of using mHealth in rural Mozambique to enhance pre-natal health promotion messaging/outreach to pregnant women.
Evaluation Methods and Results: Mobile phones were used to deliver a series of health education modules, in addition to data collection, CHW training, and a system to prompt emergency referrals. The pilot intervention design had 2 arms: with the mHealth intervention arm utilizing CHWs equipped with mobile phones and the comparison/control arm using CHWs without mobile phones. Surveys were administered at the end of the study to women in both groups to explore knowledge and awareness of danger signs during pregnancy the postpartum period among study participants. Odds ratios, confidence intervals and p-values for each indicator were calculated and compared between groups. A total of 188 women were recruited into the study, with 93 in the intervention arm and 95 controls. Mothers in the intervention arm were less likely to have ever attended school (52%) compared to the controls (74%), as well as more likely to work outside the home (68% versus 59%, respectively). Results indicate that more mothers in the intervention arm could identify at least 2 danger signs during/after delivery when compared with mothers in the control group (11.8% versus 5.3%, respectively, OR=0.4, p-value=0.05). However, knowledge of danger signs in pregnancy was statistically higher in the control group versus the intervention group (68% compared to 52%, OR=0.4, p=0.009).
Conclusions: While these pilot intervention study findings are not conclusive in terms of program effectiveness, the feasibility of using mHealth in rural Mozambique was demonstrated. Group differences between the intervention and control arm were identified and the potential bias they presented on overall study results must be further explored.
Implications for research and/or practice: The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality prenatal care. World Vision’s mHealth intervention shows promise as a feasible way to enhance knowledge among women of childbearing age in a rural, developing country. Further research and support to examine this platform is warranted.