Addition of mHealth (mobile health) for family planning support in Kenya: disparities in access to mobile phones and associations with contraceptive knowledge and use.

Background Recently mobile health (mHealth) has been implemented in Kenya to support family planning. Our objectives were to investigate disparities in mobile phone ownership and to examine the associations between exposure to family planning messages through mHealth (stand-alone or combined with other channels such as public forums, informational materials, health workers, social media and political/religious/community leaders' advocacy) and contraceptive knowledge and use. Methods Logistic and Poisson regression models were used to analyze the 2014 Kenya Demographic and Health Survey. Results Among 31 059 women, 86.7% had mobile phones and were more likely to have received higher education, have children ≤5 y of age and tended to be wealthier or married. Among 7397 women who were sexually active, owned a mobile phone and received family planning messages through at least one channel, 89.8% had no exposure to mHealth. mHealth alone was limited in improving contraceptive knowledge and use but led to intended outcomes when used together with four other channels compared with other channels only (knowledge: incidence rate ratio 1.084 [95% confidence interval {CI} 1.063-1.106]; use: odds ratio 1.429 [95% CI 1.026-1.989]). Conclusions Socio-economic disparities existed in mobile phone ownership, and mHealth alone did not improve contraceptive knowledge and use among Kenyan women. However, mHealth still has potential for family planning when used with existing channels.

[1]  Alison L. Drake,et al.  Short message service communication improves exclusive breastfeeding and early postpartum contraception in a low‐ to middle‐income country setting: a randomised trial , 2018, BJOG : an international journal of obstetrics and gynaecology.

[2]  G. Omosa-Manyonyi,et al.  Prevalence and Factors Associated with Contraceptive Use Among Kenyan Women Aged 15–49 Years , 2018, AIDS and Behavior.

[3]  Nawal M. Nour,et al.  Providing support to pregnant women and new mothers through moderated WhatsApp groups: a feasibility study. , 2018, mHealth.

[4]  C. Birungi,et al.  Poverty as a barrier to antiretroviral therapy access for people living with HIV/AIDS in Kenya , 2018, African journal of AIDS research : AJAR.

[5]  I. Askew,et al.  Ambivalence in pregnancy intentions: The effect of quality of care and context among a cohort of women attending family planning clinics in Kenya , 2018, PloS one.

[6]  Sun-young Kim,et al.  Mapping mHealth (mobile health) and mobile penetrations in sub-Saharan Africa for strategic regional collaboration in mHealth scale-up: an application of exploratory spatial data analysis , 2017, Globalization and Health.

[7]  D. Zurovac,et al.  Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya , 2017, BMC Research Notes.

[8]  Abdul Momin Kazi,et al.  Assessing Mobile Phone Access and Perceptions for Texting-Based mHealth Interventions Among Expectant Mothers and Child Caregivers in Remote Regions of Northern Kenya: A Survey-Based Descriptive Study , 2017, JMIR public health and surveillance.

[9]  Khanjan Mehta,et al.  Value propositions of mHealth projects , 2016, Journal of medical engineering & technology.

[10]  Daniel Opoku,et al.  A systematic review of randomized controlled trials of mHealth interventions against non-communicable diseases in developing countries , 2016, BMC Public Health.

[11]  K. Klipstein‐Grobusch,et al.  Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review , 2016, PloS one.

[12]  Julia Walsh,et al.  Using mHealth to Improve Usage of Antenatal Care, Postnatal Care, and Immunization: A Systematic Review of the Literature , 2015, BioMed research international.

[13]  A. Labrique,et al.  Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review* , 2015, Tropical medicine & international health : TM & IH.

[14]  Arul Chib,et al.  mHealth Adoption in Low-Resource Environments: A Review of the Use of Mobile Healthcare in Developing Countries , 2015, Journal of health communication.

[15]  C. Pagliari,et al.  Effectiveness of mHealth interventions for maternal, newborn and child health in low– and middle–income countries: Systematic review and meta–analysis , 2014, Journal of global health.

[16]  Clara B. Aranda-Jan,et al.  Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa , 2014, BMC Public Health.

[17]  Temitope A Folaranmi mHealth in Africa: challenges and opportunities , 2014, Perspectives in public health.

[18]  K. L'Engle,et al.  There are some questions you may not ask in a clinic: Providing contraception information to young people in Kenya using SMS , 2013, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[19]  Caroline O. Buckee,et al.  Heterogeneous Mobile Phone Ownership and Usage Patterns in Kenya , 2012, PloS one.

[20]  S. Choi,et al.  A randomized controlled trial of the impact of a family planning mHealth service on knowledge and use of contraception. , 2017, Contraception.