Text messages effective in medical abortion randomized controlled trial‏

A South African study published in the Journal of Medical Internet Research's mHealth and uHealth finds that text messaging is a good medium to guide and support women through medical abortion, legal in South Africa.

Nevertheless, access and acceptability are hampered by the current protocol requiring a follow-up visit to assess abortion completion, according to researchers.

"It is hoped that this study may contribute to the successful expansion of medical abortion provision aided by a technology that is increasingly ubiquitous--mobile phones," concludes the article, which notes that South Africa has a very high level of mobile phone ownership.

Mobile phones were used several ways in the study: text messages coaching women through the medical abortion process; self-assessment of abortion completion and provision of family planning information and encouragement via a mobisite (website optimized for mobile phones), Mxit (a popular South African mobile instant message chat and social network) and text messaging.

In the study, 226 women received the full intervention, of which 190 returned and were interviewed at their clinic follow-up visit. Nearly 98 percent of participants said that the SMS helped them through the medical abortion. An SMS self-assessment questionnaire was attempted by 90.3 percent of the women, and of those 86.3 percent reached an endpoint of the questionnaire. 

"Text messages were chosen for coaching because they can be timed (i.e., sent at a particular time and date), and are a private means of communication if recipients have their own phones (which is largely the case in South Africa)," states the article.

When it comes to mobile phone privacy, 86.3 percent of participants said that it was not likely or possible that someone would see SMS on their phone, and 80 percent indicated that their phone was private enough for them to feel comfortable receiving text messages related to abortion. Consequently, the authors recommend that phone privacy needs to be protected in similar settings. 

According to the mHealth Alliance, research shows that many women's health problems in low-income countries, such as maternal mortality and unintended pregnancies, are directly linked to gender inequity. Last year, the mHealth Alliance released a Gender Analytical Framework to help mobile healthcare implementers better understand the implications of gender issues for their mHealth projects.  Though women are commonly the beneficiaries of mHealth projects, the organization argues that women are rarely equal participants in the development of mHealth interventions.

To learn more:
- read the JMIR article

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