Strengthening the home-to-facility continuum of newborn and child health care through mHealth: Evidence from an intervention in rural Malawi

  • Jean Christophe Fotso
  • Lauren Bellhouse
  • Linda Vesel Concern Worldwide US, New York, USA UNICEF, New York, USA
  • Zachariah Jezman
Keywords: mHealth, Newborn and child health, Home-to-facility continuum of care, Malawi, sub-Saharan Africa


This paper assesses the impact of a mobile health (mHealth) project on uptake of home-based care for newborn and child health, and investigates the extent to which uptake of home-based care resulted in lessened pressure on health facilities for conditions that can be handled at the household level. It uses mixed methods consisting of cross-sectional household surveys data from a quasi-experimental pre-test post-test design as well as qualitative data. The results show a large, positive effect of the project on the aggregate home-based care for child health, and a sharp, negative impact on facility-based care seeking for fever among children whose mothers/caretakers used the services offered by the intervention. Reasons for using the services mainly relate to the potential of avoiding unnecessary trips to the health facility for care that could be provided at home. The project provides insights on mHealth and community-based programming to improve newborn and child health care delivery.

Author Biographies

Jean Christophe Fotso
Concern Worldwide US, New York, USA
Lauren Bellhouse
Zachariah Jezman
VillageReach, Malawi