Strengthening health systems for improved access to maternal, newborn and child health services: why mHealth should be part of the solution, and why rigorous, theory-based evaluations matter

Jean Christophe Fotso, Concern Worldwide U.S., Inc.
Jessica Crawford, VillageReach
A. Camielle Noordam, Universiteit Maastricht

The potentials of the field of mobile health (mHealth) have not yet been fully harnessed to improve maternal, newborn and child health (MNCH). An MNCH mHealth pilot named CCPF was launched in Malawi, consisting of a toll-free case management hotline and a mobile messaging service. This paper uses quantitative and qualitative data to assess the impact of CCPF, and discusses opportunities for scale and integration into wider health systems. CCPF had significant impact on bed net use, breastfeeding within one hour, antenatal care initiation, and institutional delivery. A negative effect of facility-based fever treatment suggests that CCPF helped women avoid unnecessary trips to health facilities, an interpretation corroborated in the qualitative data. The Malawi Ministry of Health endorsed the project and is supporting efforts to bring it to scale. Most mHealth interventions lack rigorous evaluation designs, and are rarely designed with a roadmap for integration into broader health systems.