Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial
Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial
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DOI：
10.1111/j.1471-0528.2012.03413.x
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发表时间：
2012-09-01
影响因子：
5.8
通讯作者：
Rasch, V.
中科院分区：
文献类型：
--
作者：
Lund, S.;Hemed, M.;Rasch, V.
Lund S, Hemed M, Nielsen B, Said A, Said K, Makungu M, Rasch V. .手机作为健康沟通工具提高桑给巴尔熟练助产士：一项随机对照试验。问卷2012;119:12561264。目的探讨在资源有限的情况下，移动电话干预与熟练分娩出勤率之间的关系。设计实用的集群随机对照试验，以初级卫生保健设施为随机化单位。在桑给巴尔建立初级保健设施。在选定的初级卫生保健机构之一接受产前护理的2,550名孕妇（1311名干预孕妇和1239名对照孕妇）被纳入第一次产前护理检查，并随访至分娩后42天。所有孕妇都有资格参加研究。方法采用简单随机法将桑给巴尔6个县的24家初级卫生保健机构分为移动电话干预组（n = 12）和标准护理组（n = 12）。干预包括短信服务（SMS）和移动电话代金券组成部分。主要结果测量：熟练的分娩出勤率。结果：手机干预与熟练接生人员的增加有关：干预组中60%的妇女与熟练接生人员接生的对照组中47%的妇女相比。该干预措施显著提高了城市妇女熟练接生人员的比例（优势比为5.73；95%可信区间为1.5121.81），但没有影响到农村妇女。结论：移动电话干预显著提高了城镇妇女熟练接生率。移动电话解决方案可能有助于挽救妇女及其新生儿的生命，有助于实现千年发展目标4和5，发展中国家妇幼保健政策制定者应予以考虑。
Please cite this paper as: Lund S, Hemed M, Nielsen B, Said A, Said K, Makungu M, Rasch V. Mobile phones as a health communication tool to improve skilled attendance at delivery in Zanzibar: a cluster-randomised controlled trial. BJOG 2012;119:12561264. Objective To examine the association between a mobile phone intervention and skilled delivery attendance in a resource-limited setting. Design Pragmatic cluster-randomised controlled trial with primary healthcare facilities as the unit of randomisation. Setting Primary healthcare facilities in Zanzibar. Population Two thousand, five hundred and fifty pregnant women (1311 interventions and 1239 controls) who attended antenatal care at one of the selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. All pregnant women were eligible for study participation. Methods Twenty-four primary healthcare facilities in six districts in Zanzibar were allocated by simple randomisation to either mobile phone intervention (n = 12) or standard care (n = 12). The intervention consisted of a short messaging service (SMS) and mobile phone voucher component. Main outcome measures Skilled delivery attendance. Results The mobile phone intervention was associated with an increase in skilled delivery attendance: 60% of the women in the intervention group versus 47% in the control group delivered with skilled attendance. The intervention produced a significant increase in skilled delivery attendance amongst urban women (odds ratio, 5.73; 95% confidence interval, 1.5121.81), but did not reach rural women. Conclusions The mobile phone intervention significantly increased skilled delivery attendance amongst women of urban residence. Mobile phone solutions may contribute to the saving of lives of women and their newborns and the achievement of Millennium Development Goals 4 and 5, and should be considered by maternal and child health policy makers in developing countries.