Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Apr 24;3(Suppl 2):e000583.
doi: 10.1136/bmjgh-2017-000583. eCollection 2018.

Unpacking the performance of a mobile health information messaging program for mothers (MomConnect) in South Africa: evidence on program reach and messaging exposure

Amnesty E LeFevre  1   2 , Pierre Dane  3 , Charles J Copley  4 , Cara Pienaar  3 , Annie Neo Parsons  3 , Matt Engelhard  4 , David Woods  5 , Marcha Bekker  6 , Peter Benjamin  7 , Yogan Pillay  8 , Peter Barron  8   9 , Christopher John Seebregts  2   3 , Diwakar Mohan  1
Affiliations
Review

Unpacking the performance of a mobile health information messaging program for mothers (MomConnect) in South Africa: evidence on program reach and messaging exposure

Amnesty E LeFevre et al. BMJ Glob Health. .

Abstract

Despite calls to address broader evidence gaps in linking digital technologies to outcome and impact level health indicators, limited attention has been paid to measuring processes pertaining to the performance of programs. In this paper, we assess the program reach and message exposure of a mobile health information messaging program for mothers (MomConnect) in South Africa. In this descriptive study, we draw from system generated data to measure exposure to the program through registration attempts and conversions, message delivery, opt-outs and drop-outs. Using a logit model, we additionally explore determinants for early registration, opt-outs and drop-outs. From August 2014 to April 2017, 1 159 431 women were registered to MomConnect; corresponding to half of women attending antenatal care 1 (ANC1) and nearly 60% of those attending ANC1 estimated to own a mobile phone. In 2016, 26% of registrations started to get women onto MomConnect did not succeed. If registration attempts were converted to successful registrations, coverage of ANC1 attendees would have been 74% in 2016 and 86% in 2017. When considered as percentage of ANC1 attendees with access to a mobile phone, addressing conversion challenges bring registration coverage to an estimated 83%-89% in 2016 and 97%-100% in 2017. Among women registered, nearly 80% of expected short messaging service messages were received. While registration coverage and message delivery success rates exceed those observed for mobile messaging programs elsewhere, study findings highlight opportunities for program improvement and reinforce the need for rigorous and continuous monitoring of delivery systems.

Keywords: child health; maternal health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Measuring the flow of registration and message delivery. The red line denotes the pathway of registration flow while the light blue line reflects the message delivery pathway. The dotted nature of the lines is intended to denote the potential for breaks in the continuity of data flow at each point in the pathway. Analyses in this paper focus only on registration and message delivery data. WASP, Wireless Access Service Provider; Vumi/SEED, Messaging engine for the delivery of SMS; OpenHIM, Middleware system for enabling interoperability with health information systems; DHIS2, District Health Information System 2, includes data on antenatal care registration.
Figure 2
Figure 2
Overview of MomConnect enrolment flow from 1 January 2016 to 31 December 2016. USSD, Unstructured Supplementary Service Data.
Figure 3
Figure 3
Percentage of MomConnect registered users out of those attending ANC1 from January 2015 to April 2017 by province.
Figure 4
Figure 4
Message delivery success rates by month and province from December 2016 to May 2017.
See this image and copyright information in PMC

References

    1. Agarwal S, LeFevre AE, Lee J, et al. . Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist. BMJ 2016;352:i1174 10.1136/bmj.i1174 - DOI - PubMed
    1. Watterson JL, Walsh J, Madeka I. Using mHealth to Improve Usage of Antenatal Care, Postnatal Care, and Immunization: A Systematic Review of the Literature. Biomed Res Int 2015;2015:1–9. 10.1155/2015/153402 - DOI - PMC - PubMed
    1. Free C, Phillips G, Watson L, et al. . The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med 2013;10:e1001363 10.1371/journal.pmed.1001363 - DOI - PMC - PubMed
    1. Free C, Phillips G, Galli L, et al. . The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med 2013;10:e1001362 10.1371/journal.pmed.1001362 - DOI - PMC - PubMed
    1. MacLeod BB, Phillips J, Stone A, et al. . The Architecture of a Software System for Supporting Community-based Primary Health Care with Mobile Technology: The Mobile Technology for Community Health (MoTeCH) Initiative in Ghana. Online J Public Health Inform 2012;4:1–17. 10.5210/ojphi.v4i1.3910 - DOI - PMC - PubMed

LinkOut - more resources