Effectiveness of SMS-Based Message Framing Intervention for Improving Maternal Health Service Uptake and Newborn Care Practice in Rural Jimma Zone, Ethiopia: Protocol for Cluster Randomized Controlled Trial (Preprint)

Abstract

Ethiopia is a country with a high toll of maternal and neonatal mortality rates. In 2019/2020, maternal and newborn mortality rates were estimated to be 412/ 100,0000 births and 30 / 10,000 births, respectively. While mHealth's interventions to improve maternal and neonatal health management have shown promising results, there are still insufficient scientific studies to assess the effectiveness of mobile phone messaging-based message framing for maternal and newborn health.

The aim of this research is to examine the effectiveness of mobile phone messaging-based message framing for improving the use of mothers and new-borns health services in the Jimma Zone, Ethiopia

A three-arm cluster-randomized trial design is being employed to evaluate the effects of mobile phone-based intervention effects on maternal and newborn health service utilization. Trial arms are: (1) gain framed messages (2) loss framed messages, and (3) usual care. Twenty-one Health posts were randomized and 588 pregnant women who had a gestational age of < 20 weeks irrespective of their antenatal care status were randomly assigned to the trial arms. The baseline survey was conducted and the outcome of the study will be assessed after intervention which is carried out for six months. The intervention consists of a series of messages that are being dispatched every 3 days from the date of enrolment until 6 months. The control group is receiving existing care without messages. The primary outcomes of interest are antenatal visits, institutional deliveries, early postnatal care, and newborn care practice, whereas Self-reported Iron supplementation, exclusive breastfeeding, neonatal vaccinations, and maternal morbidity. The outcome will be analyzed using a generalized linear mixed model and reported according to the Consolidated Standards of Reporting Trials (CONSORT)- EHEALTH statement for randomized control trials.

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This trial is used to understand how mobile phone-based messaging will improve maternal and newborn health service utilization. It provides evidence for policy guidelines around mHealth nudging to improve maternal and newborn health.

The trial was registered on the clinical trials website https://pactr.samrc.ac.za on 4th January 2022. The trial identifier is PACTR202201753436676