The Impact of Prenatal Short Messages (SMS) on Maternal and Newborn Health

President and Fellows of Harvard College

Status: Completed

Conditions: Text Messaging; Short Message Service

Treatments: Behavioral: Good household prenatal practice; Behavioral: Full bank of SMS; Behavioral: Care seeking

Study type: Interventional

Funder types: Other

Identifiers

NCT02037087

newborn2013

Details and patient eligibility

About

It is hypothesized that delivering short messages (SMS) to pregnant women can improve maternal and newborn health outcomes. This pilot offers mothers-to-be in rural China free daily short messages (SMS) via cell phone. The aim is to advise them on (a) good household prenatal practices (GHPP) and (b) care seeking (CS) in order to improve the quality of life for mothers and newborns.

Full description

Factorial quasi-randomization is utilized to compare two groups of interventions (i.e., GHPP and CS) as well as to compare these individual interventions with a combination of the interventions. It is also possible that distinct treatments have interaction effects, and we plan to test for this. Policymakers are interested in using different strategies to enhance neonatal health. For example, the bank of SMS developed by our team is a combination of several components: reminders for regular checkups, information on GHPP, and information on CS. From a policy perspective, the evaluation of the full bank of SMS may be sufficient for the government to decide whether or not to scale up the full bank of SMS. However, to understand maternal behavior and, for policy purposes, to understand which components in the bank of SMS should be scaled up, it is important to disentangle which component contributes most to final neonatal health. Taken together, are all the components of the bank of SMS effective in changing maternal behavior and enhancing neonatal health? Which mechanisms are at play, good household prenatal care, care seeking in pregnancy, or both?

Enrollment: 4,467 patients

Sex: Female

Ages: 18 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

There were two inclusion criteria: Local pregnant women must 1) own a cell phone in the household, and 2) visit a MCHC for antenatal care during pregnancy.

Trial design

4,467 participants in 4 patient groups

Good household prenatal practice (GHPP)

Experimental group

Description:

The GHPP arm receives SMS messages regarding knowledge on nutrition, labor, non-medical pain management, breastfeeding, and depression. This arm also receives messages delivered to the control group.

Treatment:

Behavioral: Good household prenatal practice

Care seeking (CS)

Experimental group

Description:

The CS arm receives SMS messages which include danger-sign recognition and reminders for government-subsidized projects. This arm also receives messages delivered to the control group.

Treatment:

Behavioral: Care seeking

Full bank of SMS

Experimental group

Description:

This arm receives the SMS messages delivered to the GHPP, CS and control group.

Treatment:

Behavioral: Full bank of SMS

Control

No Intervention group

Description:

Control group receives SMS messages regarding: * Reminders of prenatal visits and certified skilled attendance of labor (status quo); * Fetal development in different gestational stages. The three experimental groups receive the control messages as well.