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Impact of a text messaging program on adolescent reproductive health: A cluster–randomized trial in Ghana

Author

Listed:
  • Slawa Rokicki

    (Interfaculty Initiative in Health Policy, Harvard University; Geary Institute for Public Policy, University College Dublin)

  • Jessica Cohen

    (Department of Global Health and Population, Harvard T.H. Chan School of Public Health)

  • Joshua A. Salomon

    (Department of Global Health and Population, Harvard T.H. Chan School of Public Health)

  • Günther Fink

    (Department of Global Health and Population, Harvard T.H. Chan School of Public Health)

Abstract
Objectives. To evaluate whether text-messaging programs can improve reproductive health among adolescent girls in low- and middle-income countries. Methods. We conducted a cluster–randomized controlled trial among 756 female students aged 14 to 24 years in Accra, Ghana, in 2014. We randomized 38 schools to unidirectional intervention (n=12), interactive intervention (n=12), and control (n=14). The unidirectional intervention sent participants text messages with reproductive health information. The interactive intervention engaged adolescents in text-messaging reproductive health quiz games. The primary study outcome was reproductive health knowledge at 3 and 15 months. Additional outcomes included self-reported pregnancy and sexual behavior. Analysis was by intent-to-treat. Results. From baseline to 3 months, the unidirectional intervention increased knowledge by 11 percentage points (95% confidence interval [CI]=7, 15) and the interactive intervention by 24 percentage points (95% CI=19, 28), from a control baseline of 26%. Although we found no changes in reproductive health outcomes overall, both unidirectional (odds ratio [OR]=0.14; 95% CI=0.03, 0.71) and interactive interventions (OR=0.15; 95% CI=0.03, 0.86) lowered odds of self-reported pregnancy for sexually active participants. Conclusions. Text-messaging programs can lead to large improvements in reproductive health knowledge and have the potential to lower pregnancy risk for sexually active adolescent girls.

Suggested Citation

  • Slawa Rokicki & Jessica Cohen & Joshua A. Salomon & Günther Fink, 2017. "Impact of a text messaging program on adolescent reproductive health: A cluster–randomized trial in Ghana," Working Papers 201702, Geary Institute, University College Dublin.
    • Handle: RePEc:ucd:wpaper:201702
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    References listed on IDEAS

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    1. World Bank, 2015. "The Little Data Book 2015," World Bank Publications - Books, The World Bank Group, number 21635.
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    Cited by:

    1. Ditte S Linde & Malene Korsholm & Johnson Katanga & Vibeke Rasch & Andreas Lundh & Marianne S Andersen, 2019. "One-way SMS and healthcare outcomes in Africa: Systematic review of randomised trials with meta-analysis," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    2. Franklin I Onukwugha & Lesley Smith & Dan Kaseje & Charles Wafula & Margaret Kaseje & Bev Orton & Mark Hayter & Monica Magadi, 2022. "The effectiveness and characteristics of mHealth interventions to increase adolescent’s use of Sexual and Reproductive Health services in Sub-Saharan Africa: A systematic review," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-18, January.
    3. Joël Cariolle & David A Carroll, 2022. "The Use of Digital for Public Service Provision in Sub-Saharan Africa," Working Papers hal-03004535, HAL.
    4. Melissa Hidrobo & Giordano Palloni & Daniel O. Gilligan & Jenny C. Aker & Natasha Ledlie, 2022. "Paying for Digital Information: Assessing Farmers’ Willingness to Pay for a Digital Agriculture and Nutrition Service in Ghana," Economic Development and Cultural Change, University of Chicago Press, vol. 70(4), pages 1367-1402.
    5. Tomomi Tanaka, 2019. "Human Capital Development in Ghana," World Bank Publications - Reports 34181, The World Bank Group.

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    More about this item

    Keywords

    reproductive health; sexual education; adolescent health; mobile health; text messaging; global health;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I25 - Health, Education, and Welfare - - Education - - - Education and Economic Development
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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