Adoption of Mobile Phone Messages for Delivery and Newborn Care in Bangladesh

In Bangladesh, mobile phones have been adopted as a health communication tool to improve maternal and child healthcare. To understand what works and what doesn’t work for mobile phone based messages around delivery, postpartum and newborn care in resource limited settings we interviewed 33 women who enrolled in an educational service that provides twice weekly voice or text messages to pregnant women and mothers of 0-11 month old babies and had participated in a survey. This follow up qualitative exploratory study showed that women appreciated receiving messages around newborn care and nutrition information over pregnancy messages. Women in low- income households faced challenges accessing messages on shared phones while those with low literacy and limited technological knowledge preferred to receive voice messages over text messages. Husband’s endorsement of the service improved women’s adoption of the messages. Knowledge on additional consultation service and information on how to enroll in the service for later pregnancies was found to be low. Some participants were reluctant to pay for educational messages and avoided the calls. Women’s healthcare practices suggested growing awareness on biomedical practices although women from low- income households were more likely to follow traditional unskilled birthing and newborn care practices at cultural influences unless experienced complications. Besides providing contextual messages, a holistic response is required that includes; training local birth attendants, sensitizing female family members who organize the home based deliveries, and establishing a subsidized referral system to improve birth related health outcomes in low- income households.