Effectiveness of an Innovative mHealth Intervention to Improve Coverage and Quality of Proven Maternal and Newborn Health Interventions in Rural India: A Quasi-Experimental Study

Presenter: Kapil Dave, SEWA Rural

Background:  The objective of this study is to assess effectiveness of a mHealth intervention to improve coverage and quality of proven community based Maternal and Newborn Health (MNH) interventions at scale in rural India.

Method: This study was conducted among all 32 intervention (population: 28,000) and 54 control villages (population: 30,000) in tribal areas of Gujarat, India using quasi-experimental study design in May, 2014 after completing one year of implementation. The mHealth intervention is a mobile-phone application in form of a job-aid to village-level frontline workers called ASHAs. Primary outcome of interest was coverage of proven MNH interventions. A household survey was done by interviewing all women who recently delivered using a structured, pre-tested questionnaire. Data analysis was done using STATA IC 10.

Results: Baseline characteristics of respondents were similar in intervention (n=50) and control (n=49) area. Coverage of early registration of pregnancy (RR: 1.4, CI: 1.1-1.9), care seeking from ASHA for newborn complications (RR:2.5 , CI:1.2-5 ), early initiation of breast feeding) (RR: 1.2, CI: 1.01-1.48 ), at least  2 home-visits by ASHA within first week after delivery (RR: 1.7, CI: 1.3-2.4) were significantly higher in intervention area compared to control area.  At least 4 ANC examinations by Nurse/Doctor, skilled birth attendance were not significantly different in intervention area compared to control area.

Interpretation: mHealth interventions can help ASHAs significantly improve coverage of MNH interventions along continuum of care in hard to reach areas. Scaling up mHealth interventions in other tribal areas might be considered.