Evidence map›Paper›PMID 29924912›Full record

Trial reportBJOG : an international journal of obstetrics and gynaecology2018

Short message service communication improves exclusive breastfeeding and early postpartum contraception in a low- to middle-income country setting: a randomised trial.

J A Unger, K Ronen, T Perrier, B DeRenzi, J Slyker, A L Drake, D Mogaka, J Kinuthia, G John-Stewart

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BJOG : an international journal of obstetrics and gynaecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06409208 (Postnatal Care and Services Utilization in Nepal), which is not on this map. Cited by 60 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 19 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06409208 nacompletednot on this mapstarted 2025, after this paper: background citation

Postnatal Care and Services Utilization in Nepal: Use of mHealth Intervention in Improving Utilization of Postpartum Care

TypeinterventionalSponsorDhulikhel HospitalRan2025 to 2026Enrolled300ConditionsPostnatal CareArmsmHealth intervention (video and reminder SMSs)
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 19 syntheses or guidelines pooled it, 98 citations in OpenAlex.

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  10. Support for healthy breastfeeding mothers with healthy term babies.The Cochrane database of systematic reviews · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 3 countries.

J A UngerDepartment of Global Health, University of Washington, Seattle, WA, USA.
K RonenDepartment of Global Health, University of Washington, Seattle, WA, USA.
T PerrierDepartment of Computer Science and Engineering, University of Washington, Seattle, WA, USA.
B DeRenziDepartment of Computer Science, University of Cape Town, Cape Town, South Africa.
J SlykerDepartment of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
A L DrakeDepartment of Global Health, University of Washington, Seattle, WA, USA.
D MogakaDepartment of Research and Programmes, Kenyatta National Hospital, Nairobi, Kenya.
J KinuthiaDepartment of Research and Programmes, Kenyatta National Hospital, Nairobi, Kenya.
G John-StewartDepartment of Global Health, University of Washington, Seattle, WA, USA.
University of Washington · USKenyatta National Hospital · KEUniversity of Cape Town · ZA

Funding

WOMEN'S REPRODUCTIVE HEALTH RESEARCH CAREER DEVELOPMENTK12HD001264 · NICHD · UNIVERSITY OF WASHINGTON · PI Barbara Ann Goff · 1998 to 2026
$8.6M
Evaluation of mHealth strategies to optimize adherence and efficacy of PMTCT/ARTR01HD080460 · NICHD · UNIVERSITY OF WASHINGTON · PI JOHN-STEWART, GRACE C. · 2014 to 2018
$3.5M
Pediatric HIV-1 in Africa: Pathogenesis and ManagementK24HD054314 · NICHD · UNIVERSITY OF WASHINGTON · PI JOHN-STEWART, GRACE C. · 2006 to 2016
$1.2M
Optimizing repeat HIV testing during pregnancy and postpartum for PMTCTK01AI116298 · NIAID · UNIVERSITY OF WASHINGTON · PI DRAKE, ALISON L · 2015 to 2019
$632k
National Science FoundationNIAID NIH HHS K01 AI116298NICHD NIH HHS K12 HD001264NICHD NIH HHS K24 HD054314NICHD NIH HHS R01 HD080460NIH HHS K01AI116298NIH HHS K12HD001264NIH HHS K24HD054314NIH HHS R01HD080460University of Washington Global Center for Integrated Health of Women Adolescents and Children (Global WACh)
6 · The paper itself

Abstract

objectiveTo assess the effect of short message service (SMS) communication on facility delivery, exclusive breastfeeding (EBF), and contraceptive use.

designMobile WACh was a three-arm unblinded individually randomised controlled trial.

settingA public sector maternal child health (MCH) clinic in Nairobi, Kenya. POPULATION: Three hundred women attending antenatal care were randomised, 100 to each arm, and followed for 24 weeks postpartum. Pregnant women, at least 14 years old with access to a mobile phone and able to read SMS were eligible for participation.

methodsWomen were randomised (1:1:1) to receive one-way SMS versus two-way SMS with a nurse versus control. Weekly SMS content was tailored for maternal characteristics and pregnancy or postpartum timing.

main outcome measuresFacility delivery, EBF, and contraceptive use were compared separately between each intervention arm and the control arm by Kaplan-Meier analysis and chi-square tests using intent-to-treat analyses.

resultsThe overall facility delivery rate was high (98%) and did not differ by arm. Compared with controls, probability of EBF was higher in the one-way SMS arm at 10 and 16 weeks, and in the two-way SMS arm at 10, 16, and 24 weeks (P < 0.005 for all). Contraceptive use was significantly higher in both intervention arms by 16 weeks (one-way SMS: 72% and two-way SMS: 73%; P = 0.03 and P = 0.02 versus 57% control, respectively); however, this difference was not significant when correcting for multiple comparisons.

conclusionOne-way and two-way SMS improved EBF practices and early contraceptive use. Two-way SMS had an added benefit on sustained EBF, providing evidence that SMS messaging influences uptake of interventions that improve maternal and neonatal health. SOURCE OF

fundingFunding was provided by the National Institutes of Health (K12HD001264 to JAU, R01HD080460, K24HD054314 to GJS, and K01AI116298 to ALD), the National Science Foundation (Graduate Research Fellowship to TP and BD), as well as the University of Washington Global Center for Integrated Health of Women Adolescents and Children (Global WACh). TWEETABLE ABSTRACT: The Mobile WACh RCT demonstrates that SMS improved practice of exclusive breastfeeding and early postpartum contraception.

Indexed as

Breast FeedingCell PhoneContraceptionAdolescentAdultFemaleHumansInfant, NewbornKenyaMaternal-Child Health ServicesMedically Underserved AreaMiddle AgedOutcome Assessment, Health CarePostpartum PeriodPregnancyPrenatal Careexclusive breastfeedingfacility deliveryfamily planningmaternal child healthmHealth

Identifiers

PMID29924912
PMCPMC6179930
OpenAlexW2889359583

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.