PhD defence Girma Gilano Kaso

Keywords: mHealth, Child feeding, Meta-analysis, Africa

"The effect of mobile phone messaging on maternal and child health service uptake in southern Ethiopia: a cluster randomized controlled trial"

The present study investigated the effectiveness of mobile health (mHealth) interventions to improve maternal and child health outcomes in Ethiopia, in the wider context of Africa. It was made up of systematic reviews, meta-analyses, qualitative research, and cluster randomized controlled trials looking into child feeding, postpartum family planning and childhood vaccination. The evidence synthesis revealed that mHealth can improve child feeding practices and support vaccination and qualitative studies identified information empowerment, motivational reinforcement and strengthened client-provider communication as important mechanisms. Healthcare providers also viewed mHealth as useful for communication and follow-up, but infrastructure, technical support and online literacy remained significant challenges. Randomized trials in South Ethiopia have demonstrated that mobile messaging reduced prelacteal feeding and increased exclusive breastfeeding and postpartum modern contraceptive use, as well as timely childhood vaccination. Additionally, Health communication technologies appear effective when they complement existing health systems rather than trying to replace them, acting as a durable extension of person-centered care. The effectiveness of mHealth interventions depends less on technology itself and more on how well the intervention aligns with local social, cultural, and health-system contexts.

To summarize, the dissertation shows that theory-informed and context-adapted mHealth interventions can improve maternal and child health behaviors and service utilization. It calls for the integration of sustainable and culturally sensitive mHealth strategies into existing healthcare systems, especially in resource-limited settings. 

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