Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 10 , ISSUE 1 ( January-March, 2018 ) > List of Articles


Mobile Technology for increasing Postpartum Family Planning Acceptability: The Development of a Mobilebased (mHealth) Intervention through a Dedicated Counselor—A Pilot Innovative Study conducted in a Tertiary Teaching Hospital of Agra, Uttar Pradesh, India

Sunita Bhagia

Keywords : Counselor mHealth, Mobile based technology, Postpartum family planning

Citation Information : Bhagia S. Mobile Technology for increasing Postpartum Family Planning Acceptability: The Development of a Mobilebased (mHealth) Intervention through a Dedicated Counselor—A Pilot Innovative Study conducted in a Tertiary Teaching Hospital of Agra, Uttar Pradesh, India. J South Asian Feder Obs Gynae 2018; 10 (1):74-80.

DOI: 10.5005/jp-journals-10006-1564

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Objective: This prospective study was undertaken to increase postpartum family planning (PPFP) acceptance among urban slum dwellers in Agra city by initiating postpartum (PP) women tracking through free phone calls and effective counseling by counselor, wherein the potential clients can be followed up and called back to the health facility for postnatal care (PNC) checkups and immunization of the newborn and helped in making an informed choice of the PPFP method best suitable to them. Materials and methods: A thorough analysis of PPFP methods at the PP center at S.N. Medical College, Agra, India, showed that the acceptance of PPFP methods was low. To boost up the PPFP program, an innovation of mobile tracking of PP women was done by a counselor. Every day the experienced counselor counseled all women in early labor in clean labour room (CLR) and recently delivered clients in PNC ward and postoperative ward on PPFP methods and services. Some of them adopted immediate PP intrauterine contraceptive device (PPIUCD) or ligation, while others were tracked by the counselor through their mobile numbers for the next 2 months. The counselor makes the following free phone calls to the potential clients: First call within 3 to 7 days of delivery Second call in 20 to 42 days of delivery Third call in 42 to 60 days of delivery This tracking was started in 2013 and completed in 2016. The results of acceptability and acceptance have been compiled. Results: • This pilot study has shown very promising results. Hence, according to this study, the effective PPFP has increased to 29.7%, which was initially 4.9%. • Also, PPFP acceptance has increased from 6% in 2012 to 73% in 2015, including all methods [condom and oral contraceptive pill (OCP)/progestin-only pill (POP) also]. The PP women who did not accept any method were referred to their respective nongovernmental organization (NGO) and they were then counseled by them and the acceptance further increased by another 5%. Conclusion: The tracking of PP women through mobile communication by the counselor in Agra city since last 48 months of implementation seems to be successful. It is going in the right direction. Linking up the recently delivered clients by the respective NGO to the nearby health facility for PPFP methods and services is playing an important role and will definitely improve with time and intensive efforts.

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  1. World Health Organization (WHO). Report of a technical consultation on birth spacing. Geneva, Switzerland: WHO; 2005.
  2. World Health Organization (WHO). Programming strategies for post-partum family planning. Geneva, Switzerland: WHO; 2013.
  3. Borda M. Family planning needs during the extended postpartum period in India (internet). Access family planning initiative brief 2009 (accessed 12 march 2015).
  4. National Family Health Survey (NFHS-3) 2005-06, vol. 1. IIPS (International Institute for Population Sciences), Mumbai, India; 2007.
  5. Ross JA, Winfrey WL. Contraceptive use, intention to use and unmet need during the extended postpartum period. Int Fam Plan Perspect 2001 Mar;27(1):20-27.
  6. District Level Household and Facility Survey (DLHS-3) 2007-08. IIPS (International Institute of Population Sciences), Mumbai, India; 2010.
  7. Grimes DA, Lopez LM, Schulz KF, Van Vliet HA, Stanwood NL. Immediate post-partum insertion of intrauterine devices. In: The Cochrane collaboration, editor. Cochrane Database Syst Rev (Internet). Chichester: John Wiley & Sons Ltd; 2010.
  8. Kumar S, Sethi R, Balasubramaniam S, Charurat E, Lalchandani K, Semba R, Sood B. Women's experience with postpartum intrauterine contraceptive device use in India. Reprod Health 2014 Apr;11:32.
  9. Patnaik UK, Mishra TK. User satisfaction and retention of Cu-T (IUD) amongst rural women in Orissa. Health Popul Perspect 2003;26(2):52-58.
  10. Performance of key HMIS indicators for all India, financial year. 2014-15, Ministry of Health & Family Welfare, Government of India Health Management information system (HMIS) portal 2014-2015.
  11. National Health Portal Ministry of Health and Family Welfare, New Delhi 2014, Janani Suraksha Yojana (accessed 12 March 2015).
  12. Michael P, Batavia H, Kaonga N, Searle S, Kwan A, Goldberger A, Fu L, Ossman J. Barriers and gaps affecting mHealth in low and middle income countries policy white paper. Center For Global Health and Economic Development, Earth Institute, Columbia, USA; 2010 May.
  13. Kallander K, Tibenderana J, Akpoghenta O, Strachen D, Hill Z, ten Asbroek A, Conteh L, Kirkwood BR, Meek SR. Mobile health approaches and lessons for increased performance and retention of community health workers in low and middle income countries: a review. J Med Internet Res 2013 Jan;15(1):e17.
  14. Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, Patel V, Haines A. The effectiveness of mobile-health technologybased health behavior change or disease management interventions, for health care consumers: a systematic review. PLoS Med 2013;10(1):e1001362.
  15. Tripney J, Kwan L, Bird K. Postabortion family planning counseling and services for women in low-income countries: a systematic review. Contraception 2013 Jan;87(1):17-25.
  16. Hou M, Hurwitz S, Kavanagh E, Fortin J, Goldberg A. Using daily text message reminders to improve adherence with oral contraceptives: a randomized controlled trial. Obstet Gynecol 2010 Sep;116(3):633-640.
  17. Castano P, Bynum J, Andres R, Lara M, Westhoff C, Effect of daily text message on oral contraceptive continuation, a randomized controlled trial. Obstet Gynecol 2012;119(1): 14-20.
  18. Lengle K, Vahdat H, Ndakidemi E, Lasway C, Zan T. evaluating feasibility, reach and potential impact of a text message family planning information service in Tanzania. Contraception 2013 Feb;87(2):251-256.
  19. Smith C, Vannak U, Sokhey L, Ngo TD, Gold J, Khut K, Edwards P, Rathavy T, Free C. Mobile Technology for Improved Family Planning Services (MOTIF): study protocol for a randomized controlled trial. Trials 2013 Dec;14:427.
  20. Smith C, Ngo TD, Gold J, Edwards P, Vannak U, Sokhey L, Machiyama K, Slaymaker E, Warnock R, McCarthy O, et al. Effect of a mobile phone-based intervention on post-abortion contraception: a randomized controlled trial in Cambodia. Bull World Health Organ 2015 Dec;93(12):842-850A.
  21. Smith C, Vannak UK, Sokhey L, Ngo TD, Gold J, Free C. Mobile Technology for Improved Family Planning (MOTIF): the development of a mobile phone-based (m-Health) intervention to support post-abortion family planning (PAFP) in Cambodia. Reprod Health 2016;13:1.
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