The effects of text reminders on the use of family planning services: evidence from an urban randomized controlled trial in Mozambique

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BMJ Global Health. 2022 Apr;7(4):e007862. doi: 10.1136/bmjgh-2021-007862.

ABSTRACT

INTRODUCTION: Reduced unmet need for contraception is associated with better health outcomes. We conducted a randomized controlled trial in Mozambique analyzing the effects of text messages encouraging use of family planning services.

METHODS: This trial was conducted among a sample of women served by the Integrated Family Planning Program implemented by Population Services International, in which community health workers provide clinical referrals for family planning services. The evaluation recruited 5,370 women between January 20 and December 18, 2020 who received a referral, reported having access to a mobile phone, and provided consent. The women were randomly assigned to a treatment group who received a series of text message reminders encouraging them to attend a clinic or a control group. An intention-to-treat analysis was conducted to analyze the effect of reminders on the likelihood of a clinic visit and contraceptive uptake. The final analysis includes 3623 women; 1747 women were lost sight of.

RESULTS: Women assigned to receive SMS reminders were slightly more likely to attend a clinic (risk difference of 2.3 percentage points, p=0.081) and to receive a contraceptive method at a clinic (2.2 percentage points, p=0.091), compared to a base rate of 48.0% and 46.9%, respectively. The effect on clinic visits is larger and statistically significant in the predefined subsample of women enrolled before the COVID-19 state of emergency (3.2 percentage points, p = 0.042).

CONCLUSION: Evidence from this trial suggests that SMS reminders are a promising boost that increases women’s likelihood of receiving contraception.

TRIAL REGISTRATION NUMBER: AEARCTR-0005383.

PMID:35428679 | DO I:10.1136/bmjgh-2021-007862

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