An mHealth SMS intervention on postpartum contraceptive use among women and couples in Kenya: a randomized controlled trial
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Objectives. To assess the effect of 2-way short message service (SMS) with a nurse on postpartum contraceptive use among individual women and couples. Methods. From 2016 to 2017, we conducted a randomized controlled trial at 2 public hospitals in western Kenya. We assigned eligible pregnant women to receive 2-way SMS with a nurse or no SMS, with the option to include male partners. We delivered automated family planning-focused SMS messages weekly until 6 months postpartum. Women and men receiving SMS could interact with nurses via SMS. In intention-to-treat analysis, we compared highly effective contraceptive (HEC) use at 6 months postpartum between groups using the χ 2 test. We used Poisson regression in adjusted analysis. Results. We randomized 260 women to 2-way SMS or control, and we enrolled 103 male partners. At 6 months postpartum, 69.9% women receiving SMS reported HEC use, compared with 57.4% in control (relative risk = 1.22; 95% confidence interval [CI] = 1.01, 1.47; P = .04). In analysis adjusted for baseline demographic differences, the adjusted relative risk for HEC use in the SMS group was 1.26 (95% CI = 1.04, 1.52; P = .02). Conclusions. Two-way SMS with a nurse, including optional male participation, increased postpartum contraceptive use. Trial Registration. ClinicalTrials.gov; identifier: NCT02781714.
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SMS-supported continuity was associated with greater use of highly effective contraception.
“SMS-supported continuity was associated with greater use of highly effective contraception and, in some analyses, with improved breastfeeding outcomes (Harrington et al., 2019; Unger et al., 2018).”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Harrington et al., 2019
The effects of interactive SMS communication with a nurse on contraception uptake varied by timing and intervention arm.
“In the included Kenyan trials, interactive SMS communication with a nurse was associated with a higher uptake of highly effective contraception at selected postpartum time points, while the effects varied by timing and intervention arm (Harrington et al., 2019; Unger et al., 2018).”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Harrington et al., 2019
In the included Kenyan trials, interactive SMS communication with a nurse was associated with a higher uptake of highly effective contraception at selected postpartum time points.
“In the included Kenyan trials, interactive SMS communication with a nurse was associated with a higher uptake of highly effective contraception at selected postpartum time points, while the effects varied by timing and intervention arm (Harrington et al., 2019; Unger et al., 2018).”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Harrington et al., 2019
SMS-supported continuity was associated with improved breastfeeding outcomes in some analyses.
“SMS-supported continuity was associated with greater use of highly effective contraception and, in some analyses, with improved breastfeeding outcomes (Harrington et al., 2019; Unger et al., 2018).”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Harrington et al., 2019
At 6 months postpartum, highly effective contraceptive use was higher with two-way SMS (69.9% vs. 57.4%; RR 1.22).
“At 6 months postpartum, highly effective contraceptive use was higher with two-way SMS (69.9%vs. 57.4%; RR 1.22); no significant difference was reported”
From Extending the continuum: Mapping post-6-week nurse/midwife-led interventions for postnatal women – A scoping review (2026) · cites this paper as Harrington et al. (2019)
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CERDIK: Aplikasi Edukasi Kontrasepsi untuk Mencegah Putus Pakai
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- Authors
- Harrington, E. K., Drake, A. L., Matemo, D., Ronen, K., Osoti, A. O., John-Stewart, G., Kinuthia, J., & Unger, J. A.
- Affiliations
- University of Nairobi (KE)
- ORCID
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2019-06
- Volume
- 109
- Issue
- 6
- Pages
- 934-941
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC6507993
- OpenAlex
- W2944034810
- Cited by
- 70
- References
- 29
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 11 · 2023: 8 · 2022: 14 · 2021: 10 · 2020: 8
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Society of Family Planning
- National Institutes of Health
- Center for AIDS Research, University of Washington
- National Institute of Allergy and Infectious Diseases (K01AI116298, P30AI027757)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Health › Social Media in Health Education
- Keywords
- postpartum contraceptive use, mobile health, text messaging intervention, family planning, male partner involvement, postpartum period, Kenya
- MeSH terms
- Adult, Contraception Behavior, Female, Hospitals, Public, Humans, Kenya, Male, Patient Acceptance of Health Care, Telemedicine, Postpartum Period, Young Adult, Self Report, Text Messaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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