Essential Coaching for Every Mother Tanzania (ECEM-TZ): Protocol for a Type 1 Hybrid Effectiveness-Implementation...

Area of Science:

• Global Health
• Digital Health
• Maternal and Child Health

Background:

• Maternal and newborn mortality remain significant concerns in low- and middle-income countries, particularly during the postnatal period.
• Tanzanian mothers often lack adequate newborn care education, despite being primary caregivers.
• Mobile health (mHealth) via text messaging presents a promising avenue to deliver timely and accessible newborn care information.

Purpose of the Study:

• To evaluate the Essential Coaching for Every Mother Tanzania (ECEM-TZ) text message intervention.
• To enhance maternal access to essential newborn care education during the first six weeks postpartum.
• To assess the intervention's impact on maternal knowledge, self-efficacy, and newborn health outcomes.

Main Methods:

• A hybrid type 1 randomized controlled trial was conducted with 124 mothers in Dar es Salaam, Tanzania.
• The ECEM-TZ intervention delivered standardized, evidence-based text messages on newborn care and danger sign recognition.
• Outcomes measured included newborn care knowledge, maternal self-efficacy, breastfeeding self-efficacy, maternal mental health, postnatal checkup attendance, and newborn morbidity/mortality.

Main Results:

• Recruitment successfully enrolled 143 participants between June and July 2024.
• 71 participants were in the control group and 72 in the intervention group.
• Data collection for the 6-week follow-up was completed by September 2024.

Conclusions:

• The study will provide evidence on the effectiveness and feasibility of text message interventions for early postnatal care in Tanzania.
• The ECEM-TZ intervention was co-designed with Tanzanian mothers and nurse midwives, ensuring cultural relevance and applicability.
• Findings will inform the scale-up of mHealth solutions to improve maternal and newborn health globally.