Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 29, 2022
Date Accepted: Sep 2, 2022
Mobile For Mothers to Augment Maternal Health Awareness and Behavior of Pregnant Women in Tribal Societies: A Randomized Quasi-Controlled mHealth Intervention
ABSTRACT
Background:
Despite several initiatives taken by government bodies, disparities in maternal health have been noticeable across India's socioeconomic gradient due to poor health awareness.
Objective:
To use an easy-to-use mHealth application (mobile for mothers - MFM) as a supporting tool to improve (a) maternal health awareness and (b) maternal health-related behavioral changes among tribal communities in India.
Methods:
Pregnant mothers between the ages of 18 and 45 were selected from 2 tribal villages of Jharkhand, India: (a) the intervention group (village A) receiving mandated government maternal care programs through m-health application and (b) the control group (village B) receiving the same government-mandated care programs via traditional means (verbally). Eight hundred Accredited social health activists (ASHA) were involved, of which 400 were allocated to the intervention group. ASHAs used the MFM application to engage with pregnant women during each home visit in the intervention group. The mHealth intervention commenced soon after the baseline survey was completed in February 2014. The end-line data were collected between November 2015 and January 2016. We calculated descriptive statistics related to demographics. The percentage changes for each variable between baseline and end line in each group was also calculated. The pre-intervention (baseline) groups were compared to the comparable end-line post-intervention group using Pearson chi-square analyses. Mantel-Haenszel tests for conditional independence were conducted to determine if the pre-to-post intervention differences in the intervention groups were significantly different from the pre-to-post intervention differences in the control groups.
Results:
Awareness regarding 5 cleans in the intervention group increased (P value <0.001) from 19.3% to 75%. Awareness about tetanus injections and the fact that pregnant mothers should receive two shots of tetanus were significantly increased (P value<0.001) from 9.9% to 67% in the intervention group. In the intervention group, awareness regarding the fact that problems like painful or burning urination and itchy genitals during pregnancy are indicative of reproductive tract infection increased (P value<0.001) from 2% to 82.2%. Similarly, knowledge about HIV testing increased (P value<0.001) from 5.3% to 77.3% in the intervention group. We also noted the percentage of mothers in the intervention group who consumed the prescribed dosage of iron tables increased (P value<0.001) from 67% to 92.3%.
Conclusions:
Mobile health intervention can augment awareness of and adherence to recommended maternal health behaviors among tribal communities in Jharkhand, India. In addition, it could act as an educational tool helping tribal societies break away from their traditional beliefs about maternal health and uptake modern healthcare recommendations.
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