Evaluation of an mHealth SMS Dialogue Strategy to Meet Women's and Couples' Postpartum Contraceptive Needs in Kenya
Evaluation of an mHealth SMS Dialogue Strategy to Meet Women's and Couples' Postpartum Contraceptive Needs in Kenya
Meeting women's need for postpartum family planning is has been acknowledged as a global
 priority in maternal and child health. The prevention of unintended pregnancies in
 sub-Saharan African countries, which carry the highest global burdens of maternal mortality
 and HIV infection, is projected to substantially decrease maternal and neonatal morbidity and
 mortality. Many barriers to contraceptive uptake exist, both within and outside of the
 postpartum time period, and include socio-cultural, economic, and supply-side factors.
 Furthermore, while the importance of engaging men in family planning programs has been
 acknowledged for decades, few interventions have succeeded in increasing male involvement in
 family planning while maintaining a focus on women's empowerment. Innovative approaches to
 meeting the family planning needs of women and couples are urgently needed.

 Public health interventions are increasingly incorporating mobile health (mHealth) approaches
 using short message service (SMS) technology in low-income countries, approaches that have
 demonstrated benefit among various reproductive health outcomes. The investigators
 hypothesize that personalized, bidirectional SMS dialogue with individual women and couples
 will increase postpartum contraceptive uptake, thereby decreasing unmet need for family
 planning in Kenya. The investigators have collaborated with the University of Washington (UW)
 Department of Computer Science and Engineering (CSE) along with Kenyan telecommunication
 providers to develop a hybrid messaging system that allows for innovative bidirectional SMS
 messaging. This system has been used successfully in maternal child health (MCH) clinics in
 Kenya. In qualitative research, women in Kenya have expressed a strong desire for mHealth
 support to provide additional education, counseling and reminders to supplement counseling by
 health workers.

 The investigators propose a randomized controlled trial (RCT) comparing the effects of
 bidirectional SMS dialogue vs. control on highly effective contraceptive use at 6 months
 postpartum among HIV negative women and couples in Nyanza Province, Kenya. Data from this RCT
 and accompanying qualitative study will contribute to innovative, scale-able strategies to
 address unmet need for contraception and increase male involvement in family planning.
Inclusion Criteria:

 -  Pregnant; at least 28 weeks gestation

 -  HIV negative

 -  Daily access to a mobile phone

 -  Planning to stay in area for 6 months postpartum

 -  Able to read/write or has trusted person to help

 Exclusion Criteria:

 -  Does not meet above criteria