The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique

Introduction: Reduction of unmet need for contraception is associated with enhanced health outcomes. We conducted a randomised controlled trial in Mozambique analysing the effects of text messages encouraging use of family planning services. Methods: This trial was conducted within a sample of women...

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Autores principales: Leight, Jessica, Hensly, Catherine, Chissano, Marcos, Safran, Elana, Ali, Liza, Dustan, Domingos, Jamison, Julian
Formato: Journal Article
Lenguaje:Inglés
Publicado: BMJ 2022
Materias:
Acceso en línea:https://hdl.handle.net/10568/141329
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author Leight, Jessica
Hensly, Catherine
Chissano, Marcos
Safran, Elana
Ali, Liza
Dustan, Domingos
Jamison, Julian
author_browse Ali, Liza
Chissano, Marcos
Dustan, Domingos
Hensly, Catherine
Jamison, Julian
Leight, Jessica
Safran, Elana
author_facet Leight, Jessica
Hensly, Catherine
Chissano, Marcos
Safran, Elana
Ali, Liza
Dustan, Domingos
Jamison, Julian
author_sort Leight, Jessica
collection Repository of Agricultural Research Outputs (CGSpace)
description Introduction: Reduction of unmet need for contraception is associated with enhanced health outcomes. We conducted a randomised controlled trial in Mozambique analysing the effects of text messages encouraging use of family planning services. Methods: This trial was conducted within a sample of women served by the Integrated Family Planning Program implemented by Population Services International, in which community health workers provide clinic referrals for family planning services. The evaluation enrolled 5370 women between 20 January and 18 December 2020 who received a referral, reported access to a mobile phone and provided consent. Women were randomly assigned to a treatment group that received a series of text message reminders encouraging them to visit a clinic or to a control arm. An intention-to-treat analysis was conducted to analyse the effect of reminders on the probability of a clinic visit and contraceptive uptake. The final analysis includes 3623 women; 1747 women were lost to follow-up. Results: Women assigned to receive the text reminders are weakly more likely to visit a clinic (risk difference 2.3 percentage points, p=0.081) and to receive a contraceptive method at a clinic (2.2 percentage points, p=0.091), relative to a base rate of 48.0% and 46.9%, respectively. The effect on clinic visits is larger and statistically significant in the prespecified subsample of women enrolled prior to the COVID-19-related state of emergency (3.2 percentage points, p=0.042). Conclusion: Evidence from this trial suggests that text message reminders are a promising nudge that increases the probability that women receive contraception.
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spelling CGSpace1413292025-10-26T13:01:28Z The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique Leight, Jessica Hensly, Catherine Chissano, Marcos Safran, Elana Ali, Liza Dustan, Domingos Jamison, Julian gender urban areas contraceptives randomized controlled trials social policies family structure health services women Introduction: Reduction of unmet need for contraception is associated with enhanced health outcomes. We conducted a randomised controlled trial in Mozambique analysing the effects of text messages encouraging use of family planning services. Methods: This trial was conducted within a sample of women served by the Integrated Family Planning Program implemented by Population Services International, in which community health workers provide clinic referrals for family planning services. The evaluation enrolled 5370 women between 20 January and 18 December 2020 who received a referral, reported access to a mobile phone and provided consent. Women were randomly assigned to a treatment group that received a series of text message reminders encouraging them to visit a clinic or to a control arm. An intention-to-treat analysis was conducted to analyse the effect of reminders on the probability of a clinic visit and contraceptive uptake. The final analysis includes 3623 women; 1747 women were lost to follow-up. Results: Women assigned to receive the text reminders are weakly more likely to visit a clinic (risk difference 2.3 percentage points, p=0.081) and to receive a contraceptive method at a clinic (2.2 percentage points, p=0.091), relative to a base rate of 48.0% and 46.9%, respectively. The effect on clinic visits is larger and statistically significant in the prespecified subsample of women enrolled prior to the COVID-19-related state of emergency (3.2 percentage points, p=0.042). Conclusion: Evidence from this trial suggests that text message reminders are a promising nudge that increases the probability that women receive contraception. 2022-04 2024-04-12T13:37:42Z 2024-04-12T13:37:42Z Journal Article https://hdl.handle.net/10568/141329 en Open Access BMJ Leight, Jessica; Hensly, Catherine; Chissano, Marcos; Safran, Elana; Ali, Liza; Dustan, Domingos; and Jamison, Julian. 2022. The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique. BMJ Global Health 7(4): e007862. https://doi.org/10.1136/bmjgh-2021-007862
spellingShingle gender
urban areas
contraceptives
randomized controlled trials
social policies
family structure
health services
women
Leight, Jessica
Hensly, Catherine
Chissano, Marcos
Safran, Elana
Ali, Liza
Dustan, Domingos
Jamison, Julian
The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique
title The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique
title_full The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique
title_fullStr The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique
title_full_unstemmed The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique
title_short The effects of text reminders on the use of family planning services: Evidence from a randomised controlled trial in urban Mozambique
title_sort effects of text reminders on the use of family planning services evidence from a randomised controlled trial in urban mozambique
topic gender
urban areas
contraceptives
randomized controlled trials
social policies
family structure
health services
women
url https://hdl.handle.net/10568/141329
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