A mixed method study on improving knowledge about pregnancy for Deaf South African women of reproductive age through an SMS-based information campaign (Preprint)

Abstract

Signing Deaf South Africans have limited access to health information and consequently limited knowledge about health. Maternal and neonatal mortality rates are high. Cell phone usage is high, making it a potentially important way of communicating about maternal and child health.

The primary aim of this study was to assess whether an SMS-based health information campaign could improve knowledge about pregnancy, antenatal care and healthy living during pregnancy for signing Deaf South African women of reproductive age. A secondary aim was to evaluate the acceptability of such an intervention.

The study was designed as a pre-test-post-test study. A baseline questionnaire assessed participants’ knowledge about pregnancy, antenatal care and healthy living during pregnancy before an SMS-based information campaign was conducted. After the campaign, an exit questionnaire was conducted, containing the same questions as the baseline questionnaire with additional questions about general acceptability and communication preferences. Results were compared between baseline and exit, using McNemar’s test and Wilcoxon signed-rank test. A focus group aimed to get further information on the impact and acceptability of SMSs. The focus group was analysed inductively.

The research showed a statistically significant improvement in overall health knowledge amongst participants. Despite this, some participants found the medical terminology difficult to understand. Several ways of improving SMS-campaigns for the Deaf were identified, including using MMSs (Multimedia Services) with a person signing messages and linking information campaigns to an interactive communication service that would enable Deaf people to pose questions. The focus group also suggested that SMSs might play a role in motivating healthy behaviour during pregnancy.

The SMS-campaign was effective in improving Deaf women’s knowledge about pregnancy, antenatal care and healthy living during pregnancy amongst Deaf women of reproductive age and has potential to impact on healthy behaviour. This contrasts with a similar study with hearing pregnant women. This suggests that SMSs may be particular effective in improving Deaf people’s health knowledge. However, attention should be given to Deaf participants’ specific needs and communication preferences to optimise impact. The potential for using SMS-campaigns to impact on behaviour should be studied.

The research was registered with the Pan African Clinical Trial Registry on December 1, 2015. Identification numbers: PACTR201512001352180.