Article Abstract

Feasibility of mHealth intervention to improve uptake of antenatal and postnatal care services in peri-urban areas of Karachi: a qualitative exploratory study

Authors: Anam Feroz, Narjis Rizvi, Saleem Sayani, Sarah Saleem

Abstract

Background: In Pakistan, poor antenatal and postnatal coverage, has accounted for nearly 70% of preventable maternal deaths. Interventions implemented to improve uptake of antenatal and postnatal care (PNC) services have not shown significant improvements. Recent increase in cellphone penetration has brought forward mHealth as a potential strategy to enhance antenatal care (ANC) and PNC uptake. The objective of this study was to explore if mHealth technology is a feasible strategy to improve uptake of preventive maternal healthcare services in peri-urban areas of Karachi.
Methods: The study employed an exploratory qualitative research design using focus group discussions (FGDs) and key-informant interviews. FGDs were conducted with pregnant women, women in the postnatal period and lady health workers (LHWs) whereas key-informant interviews were conducted with maternal neonatal and child health experts and mHealth experts. The study data was analyzed using NVivo version 11.
Results: This research found that women, healthcare providers and technology experts consider mHealth strategy has high potential to address barriers related to provision and utilization of ANC and PNC services. Healthcare providers and women understand the term mHealth and knew the benefits of mHealth services. Few of the women and healthcare providers are currently using mHealth for providing and receiving ANC and PNC services. Women and healthcare provider seemed ready for mHealth use however expressed challenges such as, illiteracy, cultural restrictions, lack of trustworthiness and misuse of technology.
Conclusions: This study informs that mHealth is operationally feasible, culturally acceptable and technologically appropriate strategy. For successful integration of mHealth technology in to existing maternal neonatal and child health service delivery structure, it is considered imperative to build a sustainable model of mHealth by involving government, local communities, telecommunication personnel, health care providers and mHealth and maternal neonatal and child health experts and through tailoring the design of the mHealth solutions in such a way that it benefits majority of women.