Mobile phone ownership, text messages, and contraceptive use: Is there a digital revolution in family planning?

This study aims to clarify the associations between mobile phone ownership use on family planning outcomes. Secondary analysis of DHS data finds that in certain contexts, mobile phone ownership may be related to increased FP uptake.

Using recent data for women 15-49 from the Demographic and Health Surveys for six countries - Ethiopia (2016), Uganda (2016), Tanzania (2015-16), Nepal (2016), Philippines (2017), and Haiti (2016-17) - we conduct multivariate logistic regression analysis to assess FP outcomes (contraceptive prevalence (CPR), modern contraceptive prevalence (mCPR), and unmet need for family planning) for mobile phone ownership and source of exposure to FP messaging. We use STATA14 for our analyses, and all results presented are weighted.

We find that in Uganda, Tanzania, and Haiti, owning a mobile phone is significantly associated with overall contraceptive use (OR = 1.38, 1.38, 1.23 respectively), modern contraceptive use (OR = 1.34, 1.30, 1.24 respectively) net of socioeconomic factors. Further, our analysis demonstrated that receiving FP information via text message was significantly associated with contraceptive uptake only in Haiti (OR = 1.62 for overall contraceptive use and OR = 1.53 for modern contraceptive use), where SMS systems have more robust connections to clinic services.

Our results indicate that in certain contexts, mobile phone ownership may be related to increased FP uptake.

These findings help inform investments in mHealth programming for family planning and reproductive health. They help clarify the potential significance of demographic patterns of mobile ownership and health outcomes, and also demonstrate the limitations of SMS services in relationship to contraceptive behaviors, reinforcing the need to connect mHealth to clinic services.