A Qualitative User Study of a Maternal Text Message-based mHealth Intervention: MAMA South Africa.

BACKGROUND: Using cell phones to support healthcare (mHealth) has been shown to improve health outcomes across a multitude of health specialties and across the world. Exploring mHealth user experiences can aid in understanding the 'how and why' an intervention was impactful. The Mobile Alliance for Maternal Action (MAMA) was a free maternal mHealth text messaging (SMS) service offered to pregnant women in Johannesburg, South Africa with a goal of improving maternal, fetal, and infant health outcomes. We conducted focus group discussions with MAMA users to learn about their experiences with the program.

OBJECTIVE: To gather opinions of participants of the MAMA maternal mHealth service regarding current healthcare atmosphere, intervention use, and intervention feedback.

METHODS: Fifteen prenatal and postnatal women attending public antenatal and postnatal care sites in central Johannesburg who were receiving free maternal health text messages (MAMA) participated in three focus group discussions. Predefined discussion topics included personal background, health care system experiences, text message program recruitment, acceptability, participant experiences and feedback.

RESULTS: Feedback regarding experiences with the health system was mixed with a few reports of positive experiences, and many more reports of negative experiences such as long waiting times, understaffed facilities and poor service. Overall acceptability for the maternal text message intervention was high. Participants reflected that messages were timely, written clearly and felt supportive. Participants reported sharing messages with friends and family.

CONCLUSIONS: These findings suggest maternal mHealth interventions, delivered through text messages can provide timely, relevant, useful and supportive information to pregnant women and new mothers especially in cases of mistrust of the healthcare system.