Effects of a mobile phone-based intervention to support post-abortion family planning in Cambodia

Conference: 
SAPC ASM 2015 - Oxford - Evidence and innovation in primary care
Talk Code: 
4D.1

The problemPost-abortion family planning (PAFP) is important to reduce subsequent unintended pregnancies. The objective of this study was to assess the effects of a mobile phone-based (mHealth) intervention to support PAFP in Cambodia.

The approach

500 women seeking safe abortion services at four Marie Stopes International Cambodia clinics were randomly allocated to the MObile Technology for Improved Family Planning (MOTIF) intervention comprising a series of automated voice-messages and counsellor support for PAFP, or to a control group. Research assistants were masked to treatment allocation. The primary outcome was self-reported use of effective contraception at four-months post-abortion. All analyses were by intention to treat. The study is registered with ClinicalTrials.gov, NCT01823861.

Findings

500 participants were randomised; 249 to the intervention and 251 to the control group. Primary outcome data were available for 431 (86.2%) participants. Self-reported effective contraception use at four-months was significantly increased with the MOTIF intervention (135/211 (64·0%) vs. 101/220 (45·9%) RR 1·39, 95% CI 1·17-1·66; p<0·001). Similar results were obtained when we considered participants lost to follow-up as non-users of contraception (135/249 (54·2% vs. 101/251 (40·2%) RR 1·35, 95% CI 1·12-1·63; p=0·002). No significant heterogeneity was shown in any of the pre-specified subgroups.

Consequences

The MOTIF intervention significantly improved use of effective contraception at four-months post-abortion. Additional mobile phone-based support for PAFP should be considered in addition to existing abortion care services.

Credits

  • Chris Smith, Marie Stopes International, London, UK
  • Judy Gold, Marie Stopes International, Phnom Penh, Cambodia
  • Thoai Ngo, Marie Stopes International, Phnom Penh, Cambodia
  • Uk Vannak
  • Ly Sokhey
  • Kazuyo Machiyama, Marie Stopes International, London, UK
  • Phil Edwards, Marie Stopes International, London, UK
  • Caroline Free, Marie Stopes International, London, UK