In 2010, the IDB Mobile Citizen Program implemented the WAWARED project "Connecting for better maternal and child health in Peru. "The project involved the development and implementation of a medical record system for maternal health, which is connected to a platform that sends personalized text messages to pregnant women, designed according to their health profile and gestational age. The text messages included reminders of prenatal check-ups, nutritional and motivational messages and, in general, health-related messages in pregnancy.
WAWARED was implemented in the Ventanilla district, Callao region, on the central coast of Peru. Women of reproductive age represent 30% of the population of Callao. The project focused on the 16 health centers located in Ventanilla. Medical care in Ventanilla does not require payment from users since more than 98% of its population qualify for comprehensive medical insurance paid by the government (Seguro Integral de Salud).
However, despite not having to pay, the frequency of prenatal care visits at Ventanilla is low. About 70% of pregnant women attend fewer than 9 prenatal visits. These levels are well below the level of 14 visits recommended by the American Health Association. In focus groups held during project preparation, most women reported that forgetting was one of the main reasons for missing prenatal control appointments.
The final sample included 1,162 women, of whom 576 received SMS reminders (treatment) and 586 did not (control). From the initial sample (all women who had made at least one prenatal checkup visit in the first 20 weeks of gestation during the period of the experiment), the dropout rate was 6%. In Peru, incoming text messages are free, so households incurred no cost when they received the intervention.
Baseline information was collected during the first prenatal check-up. Since the women were monitored until the baby was born, the results related to prenatal check-up visits and health indicators during pregnancy were electronically collected in the system developed by the project.
Pregnant women in Ventanilla Peru
Increase the number of prenatal control visits, reducing forgetting about medical visits.
Results
- Text messages increase the number of prenatal control visits by 5%, and the number of prenatal appointments on time by 10%, and also increase the probability of making at least 10 visits (one per month) by 21%.
- Heterogeneous effects of the intervention were found between different groups of women defined by their education level and distance from the health center.
- The impacts seem to be concentrated in more educated women with easier access to health centers.
- Although there was an impact on all groups, women with secondary education and living within 500 meters of the health center also increased their health behaviors, such as taking vitamins. Birth weight and APGAR score were positively affected only for this segment of the population.