Division of General Internal Medicine, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, PA, 15213, Pittsburgh, USA.
Department of Emergency Medicine, New York Presbyterian/Columbia & Cornell, 525 E 68th St Box #301, New York, NY, 10065, USA.
BMC Pregnancy Childbirth. 2022 Jun 13;22(1):485. doi: 10.1186/s12884-022-04782-0.
Access to mass media and emerging technologies (e.g., cell phones, the internet, and social media) is a social determinant of health that has been shown to profoundly influence women's health outcomes. In the African region, where women in rural settings with limited access to care are most vulnerable to maternal mortality and other pregnancy-related morbidities, mobile phone access can be an important and life-saving health determinant.
The goal of this study was to examine the association between mobile/cellular phone ownership and health behaviors of post-partum mothers in rural Malawi.
In this cross-sectional study, we recruited and consented a convenient sample of 174 post-partum mothers of 4- and 5-month-olds who were attending well-child clinics in Gowa, situated in the rural Ntcheu district of Malawi. Using logistic regression models, we hypothesized that compared to non-cell phone owners, mobile phone ownership will be predictive (greater odds) of antenatal visit frequency, exclusive breastfeeding knowledge and practices, health-seeking behaviors, and involvement in motherhood support groups; and protective (lower odds) of infant illnesses, breastfeeding challenges, and post-partum depressive symptoms.
Mobile phones were highly prevalent in this rural setting, with 45% (n = 79) of post-partum women indicating they owned at least one cell phone. Cell phone owners tended to have higher levels of education (p < 0.012) and wealth (p < 0.001). Interestingly, mobile phone ownership was only associated with exclusive breastfeeding practices; and phone owners had 75% lower odds of exclusively breastfeeding (adj. OR 0.25; 95% CI: 0.07-0.92, p = 0.038) in multivariable models. Though not statistically significant but clinically meaningful, cell phone ownership was associated with fewer depressive symptoms (adj. OR 0.84; 95% CI: 0.39-1.84, p = 0.67) and more social support (adj. OR 1.14; 95% CI: 0.61-2.13, p = 0.70).
Digital literacy and internet connectivity are social determinants of health, thus delving deeper into mothers' digital experiences to identify and ameliorate their unique barriers to full digital access will be crucial to successful implementation of digital interventions to address post-partum challenges for women in hard-to-reach settings such as ours. Such interventions are of even greater relevance as the Covid-19 pandemic has increased the urgency of reaching vulnerable, marginalized populations.
获取大众媒体和新兴技术（例如手机、互联网和社交媒体）是影响妇女健康结果的社会决定因素。在非洲地区，农村地区的妇女获得医疗服务的机会有限，她们最容易受到产妇死亡和其他与妊娠相关的疾病的影响，因此手机的普及对于健康有着重要的影响。
本研究旨在探讨手机拥有情况与马拉维农村地区产后母亲健康行为之间的关系。
在这项横断面研究中，我们招募并同意了在戈瓦参加婴幼儿诊所的 174 名产后 4-5 个月的母亲作为研究对象，该诊所位于马拉维农村的恩特切乌区。使用逻辑回归模型，我们假设与非手机拥有者相比，手机拥有者在产前就诊频率、纯母乳喂养知识和实践、寻求医疗服务行为以及参与母亲支持团体方面更具优势（更高的可能性）；而在婴儿疾病、母乳喂养挑战和产后抑郁症状方面则具有劣势（较低的可能性）。
在这个农村环境中，手机的普及程度很高，45%（n=79）的产后妇女表示她们至少拥有一部手机。手机拥有者往往具有更高的教育水平（p<0.012）和财富水平（p<0.001）。有趣的是，手机拥有情况仅与纯母乳喂养实践相关；在多变量模型中，手机拥有者纯母乳喂养的可能性低 75%（调整后的优势比 0.25；95%置信区间：0.07-0.92，p=0.038）。虽然没有统计学意义但具有临床意义的是，手机拥有情况与较少的抑郁症状相关（调整后的优势比 0.84；95%置信区间：0.39-1.84，p=0.67），并且与更多的社会支持相关（调整后的优势比 1.14；95%置信区间：0.61-2.13，p=0.70）。
数字素养和互联网连接是健康的社会决定因素，因此深入了解母亲的数字体验，以确定并改善她们在全面数字接入方面的独特障碍，对于成功实施针对难以到达地区（如我们所在地区）的妇女产后挑战的数字干预措施至关重要。随着新冠疫情的爆发，使脆弱和边缘化人群获得帮助的需求变得更加紧迫，这些干预措施显得更加重要。
