SMS-based family planning communication and its association with modern contraception and maternal healthcare use in selected low-middle-income countries (Preprint)

Abstract

In recent years, there has been a growing interest surrounding mobile phone-based health communication and service delivery methods especially in the areas of family planning (FP) and reproductive health. However, little is known regarding the role of SMS-based FP communication on the utilisation of modern contraception and maternal healthcare services in low-resource settings.

The objectives of this study were to 1) measure the coverage of SMS-based family planning (FP) communication, and 2) its association with modern contraception and maternal healthcare services (MHS) among mothers.

Cross-sectional data on 94,675 mothers (15-49 years) were collected from the latest Demographic and Health Surveys on 14 low-and-middle-income countries. The outcome variables were self-reported use of modern contraception and basic MHS (timely and adequate use of antenatal care, and of facility delivery services). Data were analysed using multivariate regression and random effect meta-analyses.

The coverage of SMS-based FP communication for the pooled sample was 5.4% (95%CI=3.71, 7.21), and was slightly higher in Africa (6.04, 95%CI=3.38, 8.70) compared with Asia (5.23, 95%CI=1.60, 8.86). Among the countries from sub-Saharan Africa, Malawi (11.92, 95%CI=11.17, 12.70) had the highest percent of receiving SMS while Senegal (1.24, 95%CI=1.00, 1.53) had the lowest. In the multivariate analysis, SMS communication shown significant association with the use of facility delivery only (2.22 (95%CI=1.95, 2.83). The strength of the association was highest for Senegal (OR=4.70, 95%CI=1.14, 7.33) and lowest for Burundi (OR=1.5; 95%CI=1.01, 2.74). Meta analyses revealed moderate heterogeneity both in the prevalence and the association between SMS communication and the utilisation of facility delivery.

Although positively associated with using facility delivery services, receiving SMS on FP does not appear to affect modern contraceptive use and other components of MHS such as timely and adequate utilisation of antenatal care.