Chandrasekar, Abinaya; Warren, Emily; Free, Caroline; Mbogua, Judie; Curtin, Esther; Gazeley, Ursula; Wong, Geoffrey; Church, Kathryn; McCarthy, Ona; (2024) mHealth interventions for postpartum family planning in LMICs: A realist review. PLOS Glob Public Health, 4 (7). e0003432-. DOI: https://doi.org/10.1371/journal.pgph.0003432
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
The unmet need for family planning is a pervasive public health concern in many low- and middle-income countries (LMICs). Mobile health (mHealth) interventions have been designed and implemented in LMIC settings to address this issue through health information dissemination via voice calls, apps, and short message services (SMS). Although the impact of mHealth programmes on postpartum family planning outcomes have been systematically reviewed, the contexts, conditions, and mechanisms underpinning programme engagement and their impact on outcomes remain unclear. This study aims to formulate hypotheses in the form of context-mechanism-outcome configurations (CMOCs) of whether, how, why, for whom, and in what contexts mHealth interventions implemented in LMICs influence postpartum family planning (PPFP) outcomes. We conducted a realist review of peer-reviewed and grey literature. Peer-reviewed literature was identified through MEDLINE, Embase, Global Health, Web of Science, and Google Scholar. Grey Literature was identified through The National Grey Literature Conference, FHI 360, Guttmacher Institute, Population Council, and MSI Reproductive Choices. Inclusion criteria were updated as the review progressed. Narrative data were analysed using dimensional analysis to build CMOCs. Two overarching concepts (underpinned by 12 CMOCs) emerged from the 37 included records: mobile phone access, use, and ownership as well as women's motivation. Women's confidence to independently own, access, and operate a mobile phone was a central mechanism leading to mHealth programme engagement and subsequent change in PPFP knowledge, awareness, and outcomes. Receiving family and social support positively interacted with this while low digital literacy and harmful gender norms pertaining to prescribed domestic duties and women's household influence were barriers to programme engagement. Intrinsic motivation for health improvement functioned at times both as a context and potential mechanism influencing mHealth programme engagement and PPFP outcomes. However, these contexts rarely occur in isolation and need to be evaluated as co-occurring phenomena. (Review registration: PROSPERO CRD42023386841).
Item Type | Article |
---|---|
Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) Faculty of Public Health and Policy > Dept of Health Services Research and Policy Faculty of Epidemiology and Population Health > Dept of Medical Statistics |
Research Centre |
Centre for Maternal, Reproductive and Child Health (MARCH) Clinical Trials Unit |
PubMed ID | 39024319 |
Elements ID | 226928 |
Official URL | http://dx.doi.org/10.1371/journal.pgph.0003432 |
Download
Filename: 2024 Chandasekar A.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Download