Effects of Mhealth Technologies on Uptake of Routine Growth Monitoring among Caregivers of Children 9-24 Months in Nyamira County, Kenya
Nyanchama, Nyang’echi Edna
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Routine growth monitoring (RGM) of children is important in assessing their health and nutritional status. This provides opportunities for implementation of interventions aimed at reducing under five mortality rates, infectious diseases and malnutrition thus ensuring achievement of the Sustainable Development Goals (SDGs) targeting good health and wellbeing. Despite the increased use of mobile health technologies in improving child health, there is still low uptake of routine growth monitoring services for children aged 9-24 months. The main objective of this study was to find out the effects of mobile health technologies on uptake of routine growth monitoring among caregivers of children aged 9-24 months in Nyamira County, Kenya. This was a quasi-experimental study. The experiment arms received Short Text Message (STM) and Voice Call (VC). Questionnaires with open and closed-ended questions and Key Informant Interview Guide (KII) were used to collect information from the respondents. Nyamira County, health facilities and KII were chosen using purposive sampling method. Caregivers of children aged 9 months were chosen using census method and the study intervention was assigned to the selected health facilities using simple random sampling method. Results of the study at baseline revealed that only 118(65.6%) of the caregivers knew the meaning of RGM. Caregivers’ knowledge on the meaning of RGM showed a significant association with level of education (χ²=29.238; df=4; p<0.0001), occupation (p=0.001), monthly income (p=0.015) and residence (χ²=6.332; df=1; p=0.012). There was tremendous improvement in the proportion of caregivers 154(85.6%) who knew the meaning of routine growth monitoring after implementation of study intervention. All the caregivers 60(100%) who received STM as well as all caregivers 60(100%) who received VC knew the meaning RGM which was an improvement of 30% and 35% respectively at the endline. Pre-intervention result revealed that 11(18.3%) caregivers from intervention arm 1 (STM), 13(21.7%) from intervention arm 2 (VC) and 14(13.3%) caregivers from control arm maintained RGM prior to recruitment in the last 8 months. Post-intervention result analysis revealed that 51(85%) caregivers from intervention arm 1, 50(83.3%) from intervention arm 2 and 2(3.3%) caregivers from control arm complied with RGM schedule. Post intervention analysis of the results revealed that caregivers from intervention arm1 9(100%) and intervention arm2 10(100%) took their children to nearby health facilities. Caregivers from the control arm gave various reasons for skipping RGM including that they forgot their TCAs 58(100%), Healthcare providers did not tell them 53(91.4%), their children were not sick 52(89.7%) among other reasons. The analysis demonstrates that in month 1 those caregivers who received STM were 6.875 times more likely to take their children for RGM compared to the control (OR = 6.875; 95 CI: 3.591 - 13.164; χ²=73.818; df=1; p<0.001). In month 1, those caregivers who received VC and HE were 6.750 times more likely to take their children for RGM compared to those in control arm (OR = 6.750; 95 CI: 3.522 - 12.938; χ²=70.612; df=1; p<0.001). Analysis of results showed that there was no statistical association in proportion of caregivers who received STM compared to those who received VC in month 1 (χ²=0.100; df=1; p=0.752). Caregivers in intervention arm 1 27(45%), intervention arm 2 26(43.3%) and control arm 27(45%) felt that mobile health technologies were good in increasing uptake of RGM. Policy makers and implementers in the health sector will find these study findings useful in deciding whether to adopt STM, VC or both in improving uptake of routine growth monitoring for children aged 9-24 months.