Citation, abstract and a comment from me below.
CITATION: Bull World Health Organ. 2025 Feb 13;103(4):255–265. doi: 10.2471/BLT.24.292145
A mobile messaging service for families on postnatal knowledge and practices: a cluster randomized trial, India
Jamie Sewan Johnston, Pooja Suri, Shirley Yan, Adithi Chandrasekar, Saumya Singla, Victoria C Ward, Seema Murthy
ABSTRACT
Objective
To evaluate the impact of a mobile messaging service that delivers World Health Organization recommendations on postnatal care to families from birth through six weeks postpartum via a messaging platform.
Methods
We randomized tertiary hospitals in four Indian states into two groups. In the treatment group, 15 hospitals promoted the messaging service to families in maternity wards before discharge following a recent birth. Nine control hospitals provided standard in-hospital information. From mid-March 2021 to mid-January 2022, we recruited mothers to participate in the study. Consenting mothers completed a face-to-face baseline survey before hospital discharge after birth and a follow-up phone survey roughly 6 weeks postpartum. Using logistic regression controlling for state-fixed effects and baseline covariates, we examine intent-to-treat estimates and report risk differences.
Findings
A total of 21 937 participants met the inclusion criteria. We observed significant positive impacts in 7 out of 11 neonatal and maternal care practices examined (P-values < 0.05). Breastfeeding increased by 3.1 percentage points, recommended cord care practices by 4.1 percentage points, skin-to-skin care with mothers by 9.2 percentage points, and skin-to-skin care by fathers by 2.2 percentage points. For recommended maternal dietary practices, we observed significant increases in adherence to guidelines advising no reduction of food intake (7.1 percentage points), no reduction of water intake (7.9 percentage points) and no restrictions on food items (10.8 percentage point; P-values < 0.01).
Conclusion
This study demonstrates that concise yet comprehensive digital messaging delivered to families during the postpartum period can effectively encourage recommended postnatal care practices.
COMMENT (NPW): It would be interesting to know more about the nine hospitals that provided standard in-hospital information, which were used as a control group. Presumably they had a variety of approaches ranging from minimal communication on post-natal practices through to consistent and effective communication (orally or through leaflets, for example). If communication to mothers is absent or poor in these settings, then we might expect any systematised method (whether digital or non-digital) to have a positive impact. It would be interesting to know the effectiveness of mobile messaging versus other means of communicating information to families. I note that the lead author (Jamie Johnston) is a member of our HIFA-WHO Collaboration group and I'll contact her to see if she would like to add anything.
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org