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Impact of smartphone-assisted prenatal home visits on women’s use of facility delivery: Results from a cluster-randomized trial in rural Tanzania

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  • Kristy Hackett
  • Curtis Lafleur
  • Peter Nyella
  • Ophira Ginsburg
  • Wendy Lou
  • Daniel Sellen

Abstract

Background: About half of births in rural Tanzania are assisted by skilled providers. Point-of-care mobile phone applications hold promise in boosting job support for community health workers aiming to ensure safe motherhood through increased facility delivery awareness, access and uptake. We conducted a controlled comparison to evaluate a smartphone-based application designed to assist community health workers with data collection, education delivery, gestational danger sign identification, and referrals. Methods: Community health workers in 32 randomly selected villages were cluster-randomized to training on either smartphone (intervention) or paper-based (control) protocols for use during household visits with pregnant women. The primary outcome measure was postnatal report of delivery location by 572 women randomly selected to participate in a survey conducted by home visit. A mixed-effects model was used to account for clustering of subjects and other measured factors influencing facility delivery. Findings: The smartphone intervention was associated with significantly higher facility delivery: 74% of mothers in intervention areas delivered at or in transit to a health facility, versus 63% in control areas. The odds of facility delivery among women counseled by smartphone-assisted health workers were double the odds among women living in control villages (OR, 1.96; CI, 1.21–3.19; adjusted analyses). Women in intervention areas were more likely to receive two or more visits from a community health worker during pregnancy than women in the control group (72% vs. 60%; chi-square = 6.9; p

Suggested Citation

  • Kristy Hackett & Curtis Lafleur & Peter Nyella & Ophira Ginsburg & Wendy Lou & Daniel Sellen, 2018. "Impact of smartphone-assisted prenatal home visits on women’s use of facility delivery: Results from a cluster-randomized trial in rural Tanzania," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-20, June.
    • Handle: RePEc:plo:pone00:0199400
    DOI: 10.1371/journal.pone.0199400
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    References listed on IDEAS

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    1. Guliani, Harminder & Sepehri, Ardeshir & Serieux, John, 2012. "What impact does contact with the prenatal care system have on women’s use of facility delivery? Evidence from low-income countries," Social Science & Medicine, Elsevier, vol. 74(12), pages 1882-1890.
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    1. Hackett, Kristy M. & Kazemi, Mina & Sellen, Daniel W., 2018. "Keeping secrets in the cloud: Mobile phones, data security and privacy within the context of pregnancy and childbirth in Tanzania," Social Science & Medicine, Elsevier, vol. 211(C), pages 190-197.

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