Trial reportReproductive health2018
mHealth intervention to improve the continuum of maternal and perinatal care in rural Guatemala: a pragmatic, randomized controlled feasibility trial.
Trial report in Reproductive health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02348840 (Mobile Health Intervention to Improve Perinatal Continuum of Care in Guatemala), which is not on this map. Cited by 44 papers, 3 of them syntheses that pooled 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.
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.
Mobile Health Intervention to Improve Perinatal Continuum of Care in Guatemala
Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Decision-support tools via mobile devices to improve quality of care in primary healthcare settings.The Cochrane database of systematic reviews · 2021Pooled it
- Quality and women's satisfaction with maternal referral practices in sub-Saharan African low and lower-middle income countries: a systematic review.BMC pregnancy and childbirth · 2020Pooled it
- The effects of on-screen, point of care computer reminders on processes and outcomes of care.The Cochrane database of systematic reviews · 2009Pooled it
- The effect of a mobile application-supported postpartum care program on mothers' breastfeeding self-efficacy and comfort: a randomized controlled study.BMC pregnancy and childbirth · 2026Trial
- The FemTech revolution: Unlocking the potential of new technology for optimizing pregnancy outcomes in low- and middle-income countries and remote areas.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Effectiveness of Digital and Remote Health Interventions in Pediatric Populations From Underserved or Rural Areas: A Systematic Review of Randomized Controlled Trials.International journal of telemedicine and applications · 2026Review
- Integrating Indigenous Maya practices and digital health tools to improve outcomes for Indigenous newborns in Guatemala: a community-based initiative.Global health action · 2025Article
- Real-time quality feedback on Doppler data for community midwives using edge-AI.Machine learning. Health · 2025Article
- Review
- Classification of the Source of 1D Doppler Ultrasound Activity in Fetal Monitoring.Computing in cardiology · 2025Article
- Article
- Implementation of a Technology-Based Mobile Obstetric Referral Emergency System (MORES): Qualitative Assessment of Health Workers in Rural Liberia.JMIR mHealth and uHealth · 2024Article
- Improving Maternity Care Where Home Births Are Still the Norm: Establishing Local Birthing Centers in Guatemala That Incorporate Traditional Midwives.Global health, science and practice · 2024Article
- Automated image transcription for perinatal blood pressure monitoring using mobile health technology.PLOS digital health · 2024Article
- Article
- The Impact of the Use of e-Partogram on Maternal and Perinatal Outcomes: A Scoping Review.Cureus · 2024Article
- A biosocial analysis of perinatal and late neonatal mortality among Indigenous Maya Kaqchikel communities in Tecpán, Guatemala: a mixed-methods study.BMJ global health · 2024Article
- Development of an educational and monitoring mobile application for pregnant women in Nigeria.Frontiers in public health · 2024Article
- Effectiveness and equity of mHealth apps for preeclampsia management in LMICs: A rapid review protocol.PloS one · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 8 institutions in 3 countries.
Funding
Abstract
BACKGROUND/
objectiveGuatemala's indigenous Maya population has one of the highest perinatal and maternal mortality rates in Latin America. In this population most births are delivered at home by traditional birth attendants (TBAs), who have limited support and linkages to public hospitals. The goal of this study was to characterize the detection of maternal and perinatal complications and rates of facility-level referral by TBAs, and to evaluate the impact of a mHealth decision support system on these rates.
methodsA pragmatic one-year feasibility trial of an mHealth decisions support system was conducted in rural Maya communities in collaboration with TBAs. TBAs were individually randomized in an unblinded fashion to either early-access or later-access to the mHealth system. TBAs in the early-access arm used the mHealth system throughout the study. TBAs in the later-access arm provided usual care until crossing over uni-directionally to the mHealth system at the study midpoint. The primary study outcome was the monthly rate of referral to facility-level care, adjusted for birth volume.
resultsForty-four TBAs were randomized, 23 to the early-access arm and 21 to the later-access arm. Outcomes were analyzed for 799 pregnancies (early-access 425, later-access 374). Monthly referral rates to facility-level care were significantly higher among the early-access arm (median 33 referrals per 100 births, IQR 22-58) compared to the later-access arm (median 20 per 100, IQR 0-30) (p = 0.03). At the study midpoint, the later-access arm began using the mHealth platform and its referral rates increased (median 34 referrals per 100 births, IQR 5-50) with no significant difference from the early-access arm (p = 0.58). Rates of complications were similar in both arms, except for hypertensive disorders of pregnancy, which were significantly higher among TBAs in the early-access arm (RR 3.3, 95% CI 1.10-9.86).
conclusionsReferral rates were higher when TBAs had access to the mHealth platform. The introduction of mHealth supportive technologies for TBAs is feasible and can improve detection of complications and timely referral to facility-care within challenging healthcare delivery contexts.
trial registrationClinicaltrials.gov NCT02348840 .
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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.