Disparities in mobile phone access and maternal health service utilization in Nigeria: A population-based survey

  • International Journal of Medical Informatics, Volume 84, No. 5, Year 2015

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Study Justification:
– The study aims to investigate the impact of mobile phone access on maternal health service utilization in Nigeria.
– Mobile communication technologies have the potential to reduce disparities in maternal health by addressing issues related to cost, distance, and infrastructure.
– Understanding the relationship between mobile phone access and maternal health outcomes is crucial for designing effective mHealth initiatives.
Highlights:
– Women without mobile phone access have significantly lower odds of utilizing antenatal care, skilled delivery, and modern contraceptives.
– These women also have lower knowledge of maternal danger signs and the benefits of antenatal and skilled delivery care.
– No differences were observed in the uptake of emergency obstetric care, postnatal services, or breastfeeding based on mobile phone access.
Recommendations for Lay Reader:
– Efforts should be made to improve women’s access to mobile phones to ensure equitable access to maternal health services.
– mHealth initiatives should consider strategies to reach women with limited mobile phone access, particularly those with the poorest maternal knowledge and care-seeking behaviors.
Recommendations for Policy Maker:
– Policies should be implemented to promote mobile phone access among women, especially those in underserved areas.
– Investments should be made in improving mobile network coverage and affordability to ensure widespread access to maternal health information and services.
– Collaboration with mobile network operators and technology companies can help facilitate the provision of mobile phones to women in need.
Key Role Players:
– Government health departments and ministries
– Mobile network operators
– Non-governmental organizations (NGOs) working in maternal health
– Technology companies
– Community health workers
Cost Items for Planning Recommendations:
– Infrastructure development for improving mobile network coverage
– Subsidies or financial assistance programs to make mobile phones more affordable for women in low-income communities
– Training programs for community health workers on mHealth interventions
– Awareness campaigns to promote the benefits of mobile phone access for maternal health
– Research and evaluation of the effectiveness of mHealth initiatives in improving maternal health outcomes

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Background: Mobile communication technologies may reduce maternal health disparities related to cost, distance, and infrastructure. However, the ability of mHealth initiatives to accelerate maternal health goals requires in part that women with the greatest health needs have access to mobile phones. Objective: This study examined if women with limited mobile phone access have differential odds of maternal knowledge and health service utilization as compared to female mobile phone users who are currently eligible to participate in maternal mHealth programs. Methods: Using household survey data from Nigeria, multivariable logistic regressions were used to examine the odds of maternal knowledge and service utilization by mobile phone strata. Results: Findings showed that in settings with unequal access to mobile phones, mHealth interventions may not reach women who have the poorest maternal knowledge and care-seeking as these women often lacked mobile connectivity. As compared to mobile users, women without mobile phone access had significantly lower odds of antenatal care utilization (OR. =. 0.48, 95%CI: 0.36-0.64), skilled delivery (OR. =. 0.56, 95%CI: 0.45-0.70), and modern contraceptive use (OR. =. 0.50, 95%CI: 0.33-0.76) after adjusting for demographic characteristics. They also had significantly lower knowledge of maternal danger signs (OR. =. 0.69, 95%CI: 0.53-0.90) and knowledge of antenatal (OR. =. 0.46, 95%CI: 0.36-0.59) and skilled delivery care benefits (OR. =. 0.62, 95%CI: 0.47-0.82). No differences were observed by mobile phone strata in uptake of emergency obstetric care, postnatal services, or breastfeeding. Conclusions: As maternal mHealth strategies are increasingly utilized, more efforts are needed to improve women’s access to mobile phones and minimize potential health inequities brought on by health systems and technological barriers in access to care.

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The study recommends focusing on improving women’s access to mobile phones to improve access to maternal health services. Some innovations to address this recommendation could include:

1. Subsidized or low-cost mobile phones: Initiatives can be implemented to provide affordable mobile phones to women in need. This can involve partnerships with mobile phone manufacturers or service providers to offer discounted or subsidized phones specifically for maternal health purposes.

2. Improved mobile network coverage: Efforts can be made to expand and improve mobile network coverage in rural areas where access to mobile phones may be limited. This can involve infrastructure development and investments in expanding network coverage to reach underserved communities.

3. Digital literacy programs: Promoting digital literacy among women is crucial to ensure they can effectively use mobile phones for accessing maternal health information and services. Initiatives can be implemented to provide training and education on how to use mobile phones, access relevant apps or websites, and navigate maternal health resources.

4. Mobile health awareness campaigns: Awareness campaigns can be conducted to educate women about the benefits of mobile health services and how they can access them using mobile phones. These campaigns can be targeted towards communities with limited mobile phone access to increase awareness and encourage adoption.

5. Partnerships with community organizations: Collaborating with local community organizations can help reach women who may not have access to mobile phones. These organizations can serve as intermediaries, providing access to mobile phones and assisting women in utilizing maternal health services through mobile technology.

By implementing these innovations, more women will have access to mobile phones and be able to benefit from maternal mHealth programs. This will help bridge the gap in access to maternal health services, improve knowledge of maternal health topics, and ultimately contribute to better maternal health outcomes.
AI Innovations Description
The recommendation to improve access to maternal health based on the study is to focus on improving women’s access to mobile phones. The study found that women without mobile phone access had significantly lower odds of utilizing maternal health services and had lower knowledge of maternal health topics compared to women with mobile phone access.

To address this disparity, efforts should be made to increase women’s access to mobile phones. This could involve initiatives such as providing subsidized or low-cost mobile phones to women in need, improving mobile network coverage in rural areas, and promoting digital literacy among women to ensure they can effectively use mobile phones for accessing maternal health information and services.

By improving access to mobile phones, more women will be able to benefit from maternal mHealth programs and have better access to antenatal care, skilled delivery, and modern contraceptives. This will help reduce maternal health disparities and improve overall maternal health outcomes.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health, the following methodology could be employed:

1. Study Design: Conduct a randomized controlled trial (RCT) to assess the impact of providing subsidized or low-cost mobile phones to women in need. Randomly assign eligible participants into two groups: an intervention group that receives the subsidized mobile phones and a control group that does not receive any intervention.

2. Sample Selection: Select a representative sample of women of reproductive age from rural areas in Nigeria, ensuring a diverse range of socioeconomic backgrounds and maternal health needs.

3. Intervention: Provide the intervention group with subsidized or low-cost mobile phones, along with instructions on how to use them for accessing maternal health information and services. Ensure that the mobile network coverage is improved in the intervention areas.

4. Data Collection: Conduct pre-intervention and post-intervention surveys to collect data on maternal knowledge, health service utilization, and mobile phone access. Use validated questionnaires to assess maternal knowledge of danger signs, antenatal care, skilled delivery care benefits, and contraceptive use. Collect data on the utilization of antenatal care, skilled delivery, modern contraceptives, emergency obstetric care, postnatal services, and breastfeeding.

5. Analysis: Use multivariable logistic regression models to compare the odds of maternal knowledge and service utilization between the intervention and control groups, adjusting for demographic characteristics. Calculate odds ratios (OR) and 95% confidence intervals (CI) to determine the impact of the intervention on maternal health outcomes.

6. Ethical Considerations: Obtain informed consent from all participants and ensure the privacy and confidentiality of their data. Adhere to ethical guidelines for conducting research involving human subjects.

7. Data Analysis and Interpretation: Analyze the collected data using appropriate statistical methods. Compare the outcomes between the intervention and control groups to assess the impact of providing subsidized mobile phones on improving access to maternal health services and knowledge.

8. Reporting: Summarize the findings in a research report or scientific publication, including the methodology, results, and conclusions. Share the results with relevant stakeholders, policymakers, and healthcare providers to inform decision-making and potential scaling up of interventions to improve access to maternal health.

By implementing this methodology, researchers can evaluate the impact of improving access to mobile phones on maternal health outcomes and provide evidence-based recommendations for scaling up interventions to reduce maternal health disparities.


Statistics:
Citations: 28
Identifiers:
DOI: 10.1016/j.ijmedinf.2015.01.016
ISSN: 13865056
Research Areas:
Community Interventions, Disparities, Health System and Policy, Maternal Access, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health, Technology and Innovations
Study Countries:
Nigeria
Study Design:
Cross Sectional Study
Study Approach:
Quantitative
Participants Gender:
Female
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