A mobile health app may improve maternal and child health knowledge and practices among rural women with limited education in Uganda: a pilot randomized controlled trial

Abstract

Objective: This article describes the impact of a mobile health app (MatHealth App) on maternal and child health knowledge and practices among women with limited education. Materials and methods: Pregnant women initiating antenatal care (ANC) were randomized (1:1) to the MatH ealth App versus routine care. Participants were followed until 6 weeks after delivery. Questionnaires for assess ing knowledge and practices were administered to participants from both arms at baseline and endline. Using logistic regression, we estimated the difference in odds of having maternal health knowledge. We reviewed clinic records to capture maternal health practices. Results: Of the 80 enrolled participants, 69 (86%) completed the study with a median follow-up of 6 months. Women in the MatHealth arm had 8.2 (P ¼ .19), 3.6 (P ¼ .14), and 6.4 (P ¼ .25), respectively higher odds of know ing (1) the recommended gestation period for starting ANC, (2) the recommended number of ANC visits, and (3) the timing and frequency of recommended human immunodeficiency virus (HIV) testing, respectively, com pared to those in the routine care arm. All women in the MatHealth App arm exclusively breastfed their babies, and brought them at 6 weeks for HIV testing, compared to the routine care arm. Just over half of the women attended at least 4 prenatal visits across the 2 arms. The main reason for noncompliance to ANC appointments was a lack of transport to the clinic. Discussion and conclusion: The app increased knowledge and practices although not reaching statistical signifi cance. Future efforts can focus on addressing social and economic issues and assessing clinical outcomes