Improving care-seeking for facility-based health services in a rural, resource-limited setting: Effects and potential of an mHealth project

  • Ariel Higgins-Steele UNICEF, Kabul, Afghanistan
  • A. Camielle Noordam Maastricht University, Maastricht, the Netherlands
  • Jessica Crawford VillageReach, Balaka, Malawi
  • Jean Christophe Fotso With Concern Worldwide US, seconded to UNICEF, New York, USA during the implementation and evaluation of the projec
Keywords: mHealth, Care-seeking, Maternal health, Child health, Malawi

Abstract

The aim of this paper was to investigate the impact of a toll-free hotline and mobile messaging service on care-seeking behaviors. Due to the low uptake of the services, the treatment on the treated estimate is used. For maternal health, the intervention had a strong, positive impact on antenatal care initiation and skilled birth attendance. No effect was observed for postnatal check-ups, receiving the recommended four antenatal care visits and vitamin A uptake. A negative effect was observed on tetanus toxoid coverage. For child health, no change was seen in child immunization, and a significant decrease was observed for care-seeking for children with fever. Different factors are associated with care-seeking, which may explain in part the variations seen across care-seeking behaviors and possible influence of exogenous factors. Introduction of mHealth services for demand generation require attention to local health systems to ensure adequate supply and quality are available.
Published
2015-06-04