Industrial and Management Systems Engineering, Benjamin M Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV, United States.
Network for Enterprise Enhancement and Development Support, Deoghar, India.
JMIR Mhealth Uhealth. 2022 Sep 21;10(9):e38368. doi: 10.2196/38368.
Despite several initiatives taken by government bodies, disparities in maternal health have been noticeable across India's socioeconomic gradient due to poor health awareness.
The aim of this study was to implement an easy-to-use mobile health (mHealth) app-Mobile for Mothers (MfM)-as a supporting tool to improve (1) maternal health awareness and (2) maternal health-related behavioral changes among tribal and rural communities in India.
Pregnant women, aged 18 to 45 years, were selected from two rural villages of Jharkhand, India: (1) the intervention group received government-mandated maternal care through an mHealth app and (2) the control group received the same government-mandated care via traditional means (ie, verbally). A total of 800 accredited social health activists (ASHAs) were involved, of which 400 were allocated to the intervention group. ASHAs used the MfM app to engage with pregnant women during each home visit in the intervention group. The mHealth intervention commenced soon after the baseline survey was completed in February 2014. The end-line data were collected between November 2015 and January 2016. We calculated descriptive statistics related to demographics and the percentage changes for each variable between baseline and end line per group. The baseline preintervention groups were compared to the end-line postintervention groups using Pearson chi-square analyses. Mantel-Haenszel tests for conditional independence were conducted to determine if the pre- to postintervention differences in the intervention group were significantly different from those in the control group.
Awareness regarding the five cleans (5Cs) in the intervention group increased (P<.001) from 143 (baseline) to 555 (end line) out of 740 participants. Awareness about tetanus vaccine injections and the fact that pregnant women should receive two shots of tetanus vaccine in the intervention group significantly increased (P<.001) from 73 out of 740 participants (baseline) to 372 out of 555 participants (end line). In the intervention group, awareness regarding the fact that problems like painful or burning urination and itchy genitals during pregnancy are indicative of a reproductive tract infection increased (P<.001) from 15 (baseline) to 608 (end line) out of 740 participants. Similarly, knowledge about HIV testing increased (P<.001) from 39 (baseline) to 572 (end line) out of 740 participants. We also noted that the number of pregnant women in the intervention group who consumed the prescribed dosage of iron tablets increased (P<.001) from 193 (baseline) out of 288 participants to 612 (end line) out of 663 participants.
mHealth interventions can augment awareness of, and persistence in, recommended maternal health behaviors among tribal communities in Jharkhand, India. In addition, mHealth could act as an educational tool to help tribal societies break away from their traditional beliefs about maternal health and take up modern health care recommendations.
OSF Registries 9U8D5; https://doi.org/10.17605/OSF.IO/9U8D5.
尽管政府机构采取了多项举措，但由于健康意识薄弱，印度的孕产妇健康状况在社会经济梯度上仍存在明显差异。
本研究旨在实施一款易于使用的移动医疗（mHealth）应用程序-Mobile for Mothers（MfM），作为一种辅助工具，以改善（1）印度部落和农村社区的孕产妇健康意识，（2）与孕产妇健康相关的行为变化。
从印度恰尔肯德邦的两个农村村庄选择 18 至 45 岁的孕妇：（1）干预组通过 mHealth 应用程序接受政府规定的孕产妇护理，（2）对照组通过传统方式（即口头）接受相同的政府规定的护理。共涉及 800 名认证的社会卫生工作者（ASHA），其中 400 名被分配到干预组。ASHA 在干预组的每次家访中使用 MfM 应用程序与孕妇进行互动。mHealth 干预在 2014 年 2 月完成基线调查后立即开始。在 2015 年 11 月至 2016 年 1 月之间收集了终线数据。我们计算了与人口统计学相关的描述性统计数据以及每组在基线和终线之间每个变量的百分比变化。使用 Pearson 卡方分析比较基线预干预组和终线后干预组。进行曼-惠特尼检验（Mantel-Haenszel test），以确定干预组的预干预到后干预差异是否与对照组有显著差异。
干预组对五个清洁（5Cs）的认识有所提高（P<.001），从 740 名参与者中的 143 名（基线）增加到 555 名（终线）。干预组对破伤风疫苗注射的认识以及孕妇应接受两次破伤风疫苗注射的事实显著增加（P<.001），从 73 名参与者增加到 372 名参与者（终线）。在干预组中，参与者对以下事实的认识有所提高：怀孕期间出现尿痛或烧灼感、生殖器瘙痒等问题表明存在生殖道感染（P<.001），从基线的 15 名参与者增加到 740 名参与者中的 608 名（终线）。同样，关于艾滋病毒检测的知识也有所增加（P<.001），从 740 名参与者中的 39 名增加到 572 名参与者（终线）。我们还注意到，干预组中服用规定剂量铁剂的孕妇人数有所增加（P<.001），从 288 名参与者中的 193 名增加到 663 名参与者中的 612 名（终线）。
mHealth 干预措施可以提高印度恰尔肯德邦部落社区对推荐的孕产妇健康行为的认识，并保持其持久性。此外，mHealth 可以作为一种教育工具，帮助部落社会摆脱对孕产妇健康的传统观念，接受现代医疗保健建议。
OSF 注册处 9U8D5；https://doi.org/10.17605/OSF.IO/9U8D5。
