Mobile phones improve antenatal care attendance in Zanzibar: a cluster randomized controlled trial.
Mobile phones improve antenatal care attendance in Zanzibar: a cluster randomized controlled trial.
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DOI：
10.1186/1471-2393-14-29
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发表时间：
2014-01-17
影响因子：
3.1
通讯作者：
Rasch V
中科院分区：
文献类型：
--
作者：
Lund S;Nielsen BB;Hemed M;Boas IM;Said A;Said K;Makungu MH;Rasch V
为了加强医疗保健系统，移动电话在医疗保健中的应用越来越受到重视。产前护理有可能降低孕产妇发病率并提高新生儿的存活率，但在撒哈拉以南非洲地区可能无法实现这一益处，因为那里的护理出勤率和质量正在下降。我们评估了资源有限环境中手机干预与产前护理之间的关联。我们的目的是综合评估产前护理，考虑产前护理的利用以及怀孕期间干预的内容和时间。这项研究是一项开放标签实用整群随机对照试验，以桑给巴尔的初级医疗机构作为随机化单位。 2550 名在选定的初级卫生保健机构接受产前保健的孕妇（1311 名干预组和 1239 名对照组）被纳入其首次产前保健就诊，并随访至产后 42 天。六个地区的 24 个初级卫生保健机构被随机分配接受手机干预或标准护理。干预措施包括手机短信和优惠券部分。主要结局指标是怀孕期间进行四次或以上产前护理。次要结果指标是破伤风疫苗接种、疟疾预防性治疗、最后一次产前护理就诊的胎龄以及产前转诊。手机干预与产前护理就诊率的增加有关。在干预组中，44% 的女性接受了四次或以上的产前检查，而对照组为 31%（OR，2.39；95% CI，1.03-5.55）。在所有次要结果指标中，产前保健服务的时间安排和质量都有改善的趋势，尽管统计上并不显着。有线母亲的移动电话干预显着增加了怀孕期间接受建议的四次产前保健就诊的妇女比例，并且随着更多妇女接受预防性保健服务、更多妇女在怀孕后期接受产前保健以及更多患有产前并发症的妇女被发现和转诊，护理质量呈改善趋势。移动电话应用程序可能有助于改善孕产妇和新生儿健康，资源有限的环境下决策者应考虑使用移动电话应用程序。 ClinicalTrials.gov，NCT01821222。
Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns’ survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during pregnancy. This study was an open label pragmatic cluster-randomised controlled trial with primary healthcare facilities in Zanzibar as the unit of randomisation. 2550 pregnant women (1311 interventions and 1239 controls) who attended antenatal care at selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome measure was four or more antenatal care visits during pregnancy. Secondary outcome measures were tetanus vaccination, preventive treatment for malaria, gestational age at last antenatal care visit, and antepartum referral. The mobile phone intervention was associated with an increase in antenatal care attendance. In the intervention group 44% of the women received four or more antenatal care visits versus 31% in the control group (OR, 2.39; 95% CI, 1.03-5.55). There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although not statistically significant. The wired mothers’ mobile phone intervention significantly increased the proportion of women receiving the recommended four antenatal care visits during pregnancy and there was a trend towards improved quality of care with more women receiving preventive health services, more women attending antenatal care late in pregnancy and more women with antepartum complications identified and referred. Mobile phone applications may contribute towards improved maternal and newborn health and should be considered by policy makers in resource-limited settings. ClinicalTrials.gov, NCT01821222.
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影响因子：
3.1
作者：
Mpembeni RN;Killewo JZ;Leshabari MT;Massawe SN;Jahn A;Mushi D;Mwakipa H
通讯作者：
Mwakipa H
影响因子：
3.3
作者：
Conrad, Paul;Schmid, Gerhrd;Sarker, Malabika
通讯作者：
Sarker, Malabika
影响因子：
168.9
作者：
Lawn, Joy E.;Blencowe, Hannah;Stanton, Cynthia
通讯作者：
Stanton, Cynthia
影响因子：
168.9
作者：
Liu, Li;Johnson, Hope L.;Black, Robert E.
通讯作者：
Black, Robert E.
影响因子：
2.8
作者：
Beeckman, Katrien;Louckx, Fred;Putman, Koen
通讯作者：
Putman, Koen