Testing Content Delivery Models for MomConnect
MQR
Testing the Effectiveness of Quality-Based WhatsApp Messaging on Vaccine Hesitancy and Childhood Immunization in a National Maternal Messaging Program
1 other identifier
interventional
8,867
1 country
1
Brief Summary
The case for mobile health (mHealth) has been gaining traction as a source to improve health outcomes of individuals. mHealth refers to the use of Information and Communication Technologies (ICT) to support health care. The ubiquity and penetration of mobile phones presents the opportunity to deliver health care services directly to citizens, with the greatest potential gains in under-resourced health ecosystems. Operating for 8 years and currently supporting 1.28 million mothers through their pregnancies and early childhood care, MomConnect represents one of the largest maternal health messaging platforms in the world. Implemented at the national level, MomConnect has been credited with being the first national-scale mHealth program of its kind and has won numerous international awards. As a WhatsApp-delivered service, MomConnect has been limited by WhatsApp's historical terms of service. In its current form, MomConnect can only start a conversation with mothers once a week by alerting them of their upcoming antenatal care (ANC) appointment. Recent changes to WhatsApp's terms of service have removed the restriction around push messages for certain programs, including MomConnect. Messages have historically been restricted to weekly conversation starters and carry only generic administrative reminder-style information. As a result, it is possible that many mothers are failing to engage with the content as much as they could. If mothers were more engaged, it could greatly increase exposure and knowledge of reducing the total number of mothers exposed to critical maternal and infant health content. With the updated terms of service, there is an opportunity to test different ways of engaging mothers. This study proposes to evaluate, through a randomized controlled trial (RCT), the relative effect of three new behaviorally-informed program models on key knowledge of and adoption of healthy behaviors.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started May 2023
Shorter than P25 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
August 16, 2022
CompletedFirst Posted
Study publicly available on registry
August 18, 2022
CompletedStudy Start
First participant enrolled
May 30, 2023
CompletedPrimary Completion
Last participant's last visit for primary outcome
February 29, 2024
CompletedStudy Completion
Last participant's last visit for all outcomes
February 29, 2024
CompletedOctober 27, 2023
October 1, 2023
9 months
August 16, 2022
October 25, 2023
Conditions
Outcome Measures
Primary Outcomes (2)
ANC visits
Binary indicator measuring whether women attended at least 8 ANC visits during pregnancy as recommended by the WHO
Based on phone survey conducted 7 weeks after expected delivery
Immunisation coverage
Binary indicator measuring whether the newborn child received all 6 vaccinations recommended at birth and 6 weeks after birth
Based on phone survey conducted 7 weeks after expected delivery
Secondary Outcomes (3)
Knowledge/Attitude Index
Based on phone survey conducted 7 weeks after expected delivery
Behaviour Index
Based on phone survey conducted 7 weeks after expected delivery
User Experience
Backend data is collected throughout users' usage of the platform; survey data based on phone survey conducted 7 weeks after expected delivery
Study Arms (4)
Appointment Reminder Model
EXPERIMENTALThis is the current MomConnect WhatsApp model (control). Mothers receive weekly conversation starter messages reminding them about their upcoming clinic appointments, providing more comprehensive and relevant maternal health information only after mothers respond to the appointment reminder.
Relevant Content Model (WhatsApp)
EXPERIMENTALMothers receive weekly conversation starter messages on WhatsApp, which carry both clinic appointment reminders along with some maternal and infant health information relevant to their pregnancy/postpartum stage. In addition, a list of "frequently asked questions" (FAQs) relevant to the week of pregnancy the mother is in are provided so that mothers can engage further with maternal health information topics relevant to them.
Relevant Content Model (SMS)
EXPERIMENTALMothers receive twice weekly conversation starter messages of 160 characters each per SMS, which carry both clinic appointment reminders as well as maternal and infant health information, relevant to their stage of pregnancy or the age of their baby. Mothers can access the list of frequently asked questions relevant to their week of pregnancy via USSD.
Relevant Content + Browsable Content Model
EXPERIMENTALThis is a combination of the Relevant Content and Browsable Content Models on WhatsApp (RCM+BCM), including appointment reminders, clinical information, a browsable menu and prompts to relevant stage-based topics. Mothers receive weekly conversation starter messages.
Interventions
The impact of MomConnect's models will be evaluated using a randomized controlled trial (RCT). Randomization will be at the individual level, where an individual refers to the "unique user", which is defined by the unique phone number used at the time of registration to MomConnect at health facilities. Randomizing control and treatment allocations ensures that the study groups will be comparable in terms of observable and unobservable characteristics in expectation. Therefore, statistical inference can shed light on the likelihood that any differences in outcome variables at the end of the intervention were caused by the intervention as compared to chance. We will also study the treatment effects on different outcomes between the different arms of the experiment - comparing outcomes across different treatment arms or outcomes in the control to outcomes in treatment arms will help us answer the aforementioned research questions.
Eligibility Criteria
You may qualify if:
- Pregnant women above the age of 18 signing up for MomConnect when being between 16-30 weeks pregnant
You may not qualify if:
- All others
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- IDinsightlead
- Reach Digital Health (formerly Praekelt.org)collaborator
Study Sites (1)
Reach Digital Health (formerly Praekelt.org)
Cape Town, South Africa
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Associate Director, Economist
Study Record Dates
First Submitted
August 16, 2022
First Posted
August 18, 2022
Study Start
May 30, 2023
Primary Completion
February 29, 2024
Study Completion
February 29, 2024
Last Updated
October 27, 2023
Record last verified: 2023-10