The Impact of an mHealth Voice Message Service (mMitra) on Infant Care Knowledge, and Practices Among Low-Income Women in India: Findings from a Pseudo-Randomized Controlled Trial

Autor: Joanne Peter, Nirmala Murthy, Nadi Nina Kaonga, Patricia Mechael, Aakash Ganju, Muthu Perumal Prakash, Subhashini Chandrasekharan
Rok vydání: 2019
Předmět:
Male
Health Knowledge
Attitudes
Practice
Infant health
030309 nutrition & dietetics
Epidemiology
Psychological intervention
law.invention
0302 clinical medicine
Randomized controlled trial
Pregnancy
law
Poverty Areas
Prospective Studies
030212 general & internal medicine
Child
mHealth
0303 health sciences
Infant Care
Obstetrics and Gynecology
Telemedicine
Female
medicine.symptom
Digital health
Adult
medicine.medical_specialty
Birth weight
India
Mothers
Child Nutrition Disorders
Article
Young Adult
03 medical and health sciences
medicine
Humans
Voice messaging
Nutrition
business.industry
Public health
Malnutrition
Infant
Newborn
Public Health
Environmental and Occupational Health
Infant
Infant
Low Birth Weight
Mobile messaging
medicine.disease
Low birth weight
Family medicine
Pediatrics
Perinatology and Child Health
Voice
Immunization
business
Cell Phone
Zdroj: Maternal and Child Health Journal
ISSN: 1573-6628
1092-7875
Popis: Objectives mHealth interventions for MNCH have been shown to improve uptake of antenatal and neonatal services in low- and middle-income countries (LMICs). However, little systematic analysis is available about their impact on infant health outcomes, such as reducing low birth weight or malnutrition among children under the age of five. The objective of this study is to determine if an age- and stage-based mobile phone voice messaging initiative for women, during pregnancy and up to 1 year after delivery, can reduce low birth weight and child malnutrition and improve women’s infant care knowledge and practices. Methods We conducted a pseudo-randomized controlled trial among pregnant women from urban slums and low-income areas in Mumbai, India. Pregnant women, 18 years and older, speaking Hindi or Marathi were enrolled and assigned to receive mMitra messages (intervention group N = 1516) or not (Control group N = 500). Women in the intervention group received mMitra voice messages two times per week throughout their pregnancy and until their infant turned 1 year of age. Infant’s birth weight, anthropometric data at 1 year of age, and status of immunization were obtained from Maternal Child Health (MCH) cards to assess impact on primary infant health outcomes. Women’s infant health care practices and knowledge were assessed through interviews administered immediately after women enrolled in the study (Time 1), after they delivered their babies (Time 2), and after their babies turned 1 year old (Time 3). 15 infant care practices self-reported by women (Time 3) and knowledge on ten infant care topics (Time 2) were also compared between intervention and control arms. Results We observed a trend for increased odds of a baby being born at or above the ideal birth weight of 2.5 kg in the intervention group compared to controls (odds ratio (OR) 1.334, 95% confidence interval (CI) 0.983–1.839, p = 0.064). The intervention group performed significantly better on two infant care practice indicators: giving the infant supplementary feeding at 6 months of age (OR 1.4, 95% CI 1.08–1.82, p = 0.009) and fully immunizing the infant as prescribed under the Government of India’s child immunization program (OR 1.531, 95% CI 1.141–2.055, p = 0.005). Women in the intervention group had increased odds of knowing that the baby should be given solid food by 6 months (OR 1.89, 95% CI 1.371–2.605, p 2.5 kg (OR 2.279, 95% CI 1.617–3.213, p Conclusions for Practice This study provides robust evidence that tailored mobile voice messages can significantly improve infant care practices and maternal knowledge that can positively impact infant child health. Furthermore, this is the first prospective study of a voice-based mHealth intervention to demonstrate a positive impact on infant birth weight, a health outcome of public health importance in many LMICs.
Databáze: OpenAIRE
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