Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial
Article first published online: 17 JUL 2012
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 119, Issue 10, pages 1256–1264, September 2012
How to Cite
Lund, S., Hemed, M., Nielsen, B., Said, A., Said, K., Makungu, M. and Rasch, V. (2012), Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology, 119: 1256–1264. doi: 10.1111/j.1471-0528.2012.03413.x
- Issue published online: 13 AUG 2012
- Article first published online: 17 JUL 2012
- Accepted 9 May 2012. Published Online 17 July 2012.
- Maternal health;
- mobile phones;
- skilled delivery attendance;
- socioeconomic determinants;
Please cite this paper as: Lund S, Hemed M, Nielsen B, Said A, Said K, Makungu M, Rasch V. Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial. BJOG 2012;119:1256–1264.
Objective To examine the association between a mobile phone intervention and skilled delivery attendance in a resource-limited setting.
Design Pragmatic cluster-randomised controlled trial with primary healthcare facilities as the unit of randomisation.
Setting Primary healthcare facilities in Zanzibar.
Population Two thousand, five hundred and fifty pregnant women (1311 interventions and 1239 controls) who attended antenatal care at one of the selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. All pregnant women were eligible for study participation.
Methods Twenty-four primary healthcare facilities in six districts in Zanzibar were allocated by simple randomisation to either mobile phone intervention (n = 12) or standard care (n = 12). The intervention consisted of a short messaging service (SMS) and mobile phone voucher component.
Main outcome measures Skilled delivery attendance.
Results The mobile phone intervention was associated with an increase in skilled delivery attendance: 60% of the women in the intervention group versus 47% in the control group delivered with skilled attendance. The intervention produced a significant increase in skilled delivery attendance amongst urban women (odds ratio, 5.73; 95% confidence interval, 1.51–21.81), but did not reach rural women.
Conclusions The mobile phone intervention significantly increased skilled delivery attendance amongst women of urban residence. Mobile phone solutions may contribute to the saving of lives of women and their newborns and the achievement of Millennium Development Goals 4 and 5, and should be considered by maternal and child health policy makers in developing countries.