Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study
- PMID: 25145970
- PMCID: PMC4158091
- DOI: 10.1186/1471-2393-14-284
Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study
Abstract
Background: Adequate antenatal care is important to both the health of a pregnant woman and her unborn baby. Given South Africa's high rate of cellphone penetration, mobile health interventions have been touted as a potentially powerful means to disseminate health information. This study aimed to increase antenatal health knowledge and awareness by disseminating text messages about clinic procedures at antenatal visits, and how to be healthy during pregnancy.
Methods: Participants recruited were pregnant women attending a primary health care facility in Cape Town. A controlled clinical trial was carried out where the intervention group (n = 102) received text messages staggered according to the week of pregnancy at the time of recruitment. The control group (n = 104) received no text messages. These text messages contained antenatal health information, and were delivered in English, Xhosa or Afrikaans, according to the preference of each participant. A baseline knowledge questionnaire with nine questions was administered prior to the intervention. The same questionnaire was used with added health-related behaviour questions for the intervention group at exit. A modified intention-to-treat analysis was done. To compare the control and intervention group's knowledge, Fisher's exact tests and two-sample t-tests tests were carried out for binary and continuous outcomes, respectively. A focus group of seven participants from the intervention group was then conducted to gain more insight into how the text messages were perceived.
Results: There was substantial loss to follow-up during the study with only 57% of the participants retained at exit. No statistically significant difference was detected between the control and intervention group in any of the nine knowledge questions at exit (all p > 0.05). Responses from the focus group indicated that the text messages acted as a welcome reminder and a source of positive motivation, and were perceived as extended care from the health care provider.
Conclusions: While the intervention failed to improve antenatal health knowledge, evidence from self-reported behaviour and the focus group suggests that text messages have the potential to motivate change in health-seeking behaviour. One should be mindful of loss to follow-up when rolling out mobile health interventions in developing country settings.
Trial registration: Pan African Clinical Trials Registry PACTR201406000841188. Registered 3 June 2014.
Similar articles
-
A Tailored mHealth Intervention for Improving Antenatal Care Seeking and Health Behavioral Determinants During Pregnancy Among Adolescent Girls and Young Women in South Africa: Development and Protocol for a Pilot Randomized Controlled Trial.JMIR Res Protoc. 2023 Sep 13;12:e43654. doi: 10.2196/43654. JMIR Res Protoc. 2023. PMID: 37703092 Free PMC article.
-
Improving Knowledge About Pregnancy for Deaf South African Women of Reproductive Age Through a Text Messaging-Based Information Campaign: Mixed Methods Study.JMIR Pediatr Parent. 2023 May 22;6:e40561. doi: 10.2196/40561. JMIR Pediatr Parent. 2023. PMID: 37213174 Free PMC article.
-
Health promotion via SMS improves hypertension knowledge for deaf South Africans.BMC Public Health. 2017 Aug 18;17(1):663. doi: 10.1186/s12889-017-4619-7. BMC Public Health. 2017. PMID: 28821288 Free PMC article. Clinical Trial.
-
Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Sep. Report No.: 18-05239-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Sep. Report No.: 18-05239-EF-1. PMID: 30354042 Free Books & Documents. Review.
-
Reducing alcohol-related harm in disadvantaged men: development and feasibility assessment of a brief intervention delivered by mobile telephone.Southampton (UK): NIHR Journals Library; 2013 Sep. Southampton (UK): NIHR Journals Library; 2013 Sep. PMID: 27466658 Free Books & Documents. Review.
Cited by
-
Impact of mHealth interventions on maternal, newborn, and child health from conception to 24 months postpartum in low- and middle-income countries: a systematic review.BMC Med. 2024 May 15;22(1):196. doi: 10.1186/s12916-024-03417-9. BMC Med. 2024. PMID: 38750486 Free PMC article. Review.
-
A systematic review of behaviour change interventions to improve maternal health outcomes in sub-Saharan Africa.PLOS Glob Public Health. 2024 Feb 20;4(2):e0002950. doi: 10.1371/journal.pgph.0002950. eCollection 2024. PLOS Glob Public Health. 2024. PMID: 38377077 Free PMC article.
-
Mapping the Role of Digital Health Interventions to Enhance Effective Coverage of Antenatal Care: A Scoping Review.J Multidiscip Healthc. 2024 Jan 5;17:71-82. doi: 10.2147/JMDH.S438097. eCollection 2024. J Multidiscip Healthc. 2024. PMID: 38196936 Free PMC article. Review.
-
A realist review of interventions targeting maternal health in low- and middle-income countries.Womens Health (Lond). 2023 Jan-Dec;19:17455057231205687. doi: 10.1177/17455057231205687. Womens Health (Lond). 2023. PMID: 37899651 Free PMC article. Review.
-
Contextual factors affecting the implementation of an anemia focused virtual counseling intervention for pregnant women in plains Nepal: a mixed methods process evaluation.BMC Public Health. 2023 Jul 6;23(1):1301. doi: 10.1186/s12889-023-16195-5. BMC Public Health. 2023. PMID: 37415262 Free PMC article. Clinical Trial.
References
-
- Department of Health . Guidelines for Maternal Care in South Africa: A Manual for Clinics, Community Health Centres and District Hospitals. Pretoria, South Africa: Department of Health; 2007.
-
- Westaway MS, Viljoen E, Wessie GM, McIntyre J, Cooper PA. Monitoring utilisation, quality & effectiveness of free antenatal care in an informal settlement in Gauteng. Curationis. 1998;21(2):57–59. - PubMed
-
- Sibeko S, Moodley J. Healthcare attendance patterns by pregnant women in Durban, South Africa. SA Fam Pract. 2006;48(10):17–17e.
-
- Hoque M, Hoque E, Kader SB. Audit of antenatal care in a rural district of KZN, South Africa. SA Fam Pract. 2008;50(3):66–66d.
-
- Department of Health . Saving Mothers 2008–2010: The Fifth Report on Confidential Enquiries into Maternal Deaths in South Africa. Pretoria, South Africa: Department of Health; 2012.
Pre-publication history
-
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2393/14/284/prepub
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical