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
. 2018 Jun 27;13(6):e0198653.
doi: 10.1371/journal.pone.0198653. eCollection 2018.

Feasibility of using smartphones by village health workers for pregnancy registration and effectiveness of mobile phone text messages on reduction of homebirths in rural Uganda

Gershim Asiki  1   2   3 , Robert Newton  2   4 , Leonard Kibirige  2 , Anatoli Kamali  2 , Lena Marions  5 , Lars Smedman  1
Affiliations

Feasibility of using smartphones by village health workers for pregnancy registration and effectiveness of mobile phone text messages on reduction of homebirths in rural Uganda

Gershim Asiki et al. PLoS One. .

Abstract

Introduction: Homebirths are common in low and middle income countries and are associated with poor child survival. We assessed the feasibility of using smartphones by village health workers for pregnancy registration and the effectiveness of health text messages (SMS) sent to pregnant women through village health workers in reducing homebirths in rural Uganda.

Methods: A non-randomised intervention study was undertaken in 26 villages. In the intervention arm, village health workers registered pregnant women (n = 262) in 13 villages using a smartphone app (doForm) and paper forms and gestation age-timed SMS were sent through village health workers to the pregnant women. In 13 control villages, (n = 263) pregnant women were registered on paper forms only and no SMS was sent. The main outcome was place of birth measured through a self-report. Logistic regression with generalised estimating equations was used to explore the effect of the intervention.

Results: Comparing 795 corresponding data fields on phone and paper revealed that numeric variable fields were 86%-95% similar while text fields were 38%-48% similar. Of the 525 pregnant women followed, 83 (15.8%) delivered at home. In the adjusted analysis, the intervention was associated with lower odds of homebirths [AOR = 0.38, 95%CI (0.15-0.97)]. Muslim religion [AOR = 4.0, 95%CI (1.72-9.34)], primary or no maternal education [AOR = 2.51, 95%CI (1.00-6.35)] and health facility distance ≥ 2 km [AOR = 2.26, 95%CI (0.95-5.40)] were independently associated with homebirths.

Conclusion: Village health workers can register pregnant women at home using phones and relay gestation age specific SMS to them to effectively reduce homebirths.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart showing enrolment and follow-up of pregnant women in rural Uganda.
Fig 2
Fig 2. Number of home deliveries in control and intervention villages in rural Uganda (2014–2015).
See this image and copyright information in PMC

References

    1. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet, 2015. 385(9966): p. 430–440. - PubMed
    1. Safer M.P., Making pregnancy safer: the critical role of the skilled attendant. World Health Organization: Geneva, 2004.
    1. Crowe S, Utley M, Costello A, Pagel C., How many births in sub-Saharan Africa and South Asia will not be attended by a skilled birth attendant between 2011 and 2015? BMC Pregnancy and Childbirth, 2012. 12(1): p. 1. - PMC - PubMed
    1. Gabrysch S, Campbell OM.Still too far to walk: literature review of the determinants of delivery service use. BMC pregnancy and childbirth, 2009. 9(1): p. 1. - PMC - PubMed
    1. Uganda Demographic Health Survey (UDHS) 2011. Kampala, Uganda. Calverton, Maryland, USA: Uganda Bureau of Statistics (UBOS) and ICF International Inc, 2012.