Effectiveness of Short Message Service (SMS) to Improve Exclusive Breastfeeding and Reduce Other Adverse Infant Feeding Practices in Yangon, Myanmar: Findings from a hospital based, community follow-up Randomized Controlled Trial
Year: 2017
Type: dissertation
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Myanmar has high child undernutrition with low exclusive breastfeeding rates (24% of infants under 6 months and 15% at 6 months). We implemented a randomized controlled trial using short message service (SMS) as a first time in Myanmar and evaluated its impact. Hypothesis is EBF rate in the intervention group would be double (30%) that of the control group (15%) when child is 6months. We used a ‘Health Belief Model’ and conducted a formative study. We recruited 353 pregnant women at 28–34 weeks gestation, from the Central Women’s Hospital and randomly allocated them into two groups. Breastfeeding and other health education SMS text messages were sent from recruitment to 6 months postpartum. Monthly follow-up phone calls were conducted at 1–6 months postpartum. Baseline assessment of women’s intention to EBF was significantly associated with working status, knowledge level, household wealth index and source of knowledge. The process evaluation found that the service delivery model was successful. The impact evaluation found that the intervention significantly increased the EBF rate over the 6 months of follow-up (Relative Risk (RR),1.54; P < .001), at each monthly follow-up visit, including at 6 months when 43% of the intervention versus 15% of the control infants were EBF (RR, 2.83; P<0.001). The intervention also significantly increased the current breastfeeding (CBF) rate (RR 1.17; P<0.001), and significantly reduced the bottle feeding (RR 0.30; P<0.001), no breastfeeding (RR,0.21; P<0.001), partial breastfeeding (RR,0.67; P=0.006) and complementary feeding (CF) rate (RR, 0.72; P=0.042) among infants at 6 months. Over the 6-month follow-up period, the SMS messages significantly increased CBF (RR, 1.07; P<0.001) and significantly reduced bottle feeding (RR,0.34; P<0.001), no breastfeeding (RR,0.27; P<0.001), partial breastfeeding (RR,0.53; P<0.001) and early introduction of CF (RR,0.63; P<0.001) compared to the control group. Over the 6-month follow-up period, the SMS messages significantly reduced acute lower-respiratory illness (RR 0.95; P<0.005) and diarrhea (RR 0.95; P= 0.008) compared to the control group. Women from the intervention group had higher breastfeeding self-efficacy during the follow-ups and no difference in social desirability scores were observed between 2 groups.
Author: Myat Pan Hmone
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3012363751