Text messaging and phone calls make it easier for new moms in Quito, Ecuador, to care for their newborns and for themselves. Results from research conducted by a faculty member in UT’s Department of Kinesiology and Health Education (KHE) are driving new protocols for this population.
Julie Maslowsky is an assistant professor in the College of Education at The University of Texas at Austin. Her focus is health and health promotion for children and adolescents, in the U.S. and abroad. For 11 years, Maslowsky and her colleagues have conducted studies on ways to improve maternal and child health in Quito, in partnership with Ecuador’s Ministry of Public Health.
In an ongoing series of studies, the team has examined various processes, including the continuum of care before, during and after hospitalizations.
“We identified follow-up care as an opportunity to improve postpartum maternal and infant health,” she says. “Great care was taken in the hospital with patients and their needs but once they were discharged, new mothers didn’t have continuing support.”
The postpartum period is a key window of opportunity for health education. Various health issues may arise after mothers and newborns leave the hospital. For mothers, recovering from delivery, breastfeeding, postpartum depression, and accessing contraception are common concerns that arise. Mothers also need support in knowing what is normal and what is a serious health problem in their infant.
Maslowsky says, “We knew that mobile technology would be key to help solve these issues. More than 90 percent of adults in Ecuador have cell phones.” Maslowsky and her colleagues developed an intervention designed to support and educate new mothers via mobile phone.
The intervention had two parts. First, each mother received a phone call from a nurse 48 hours after she was discharged from the hospital. The nurse spent approximately 30 minutes talking with the mother and educating her about common postpartum concerns for mothers and their infants, including breastfeeding, family planning, safe sleeping, vaccines, fevers, and the newborn’s eating, sleeping, and bowel habits.
After the brief educational session, the mother was then free to call or text the nurse any time during the next 30 days if she had a question or concern. In their most recent study, 178 women took part and were randomly assigned to the intervention or the control group.
The intervention produced significant improvements in health for mother and baby, which were measured when the baby was three months old. Compared to the control group, participants in the intervention group experienced positive outcomes:
- Mothers were more likely to exclusively breastfeed their infants.
- Newborns were less likely to have to go to a doctor for acute illnesses.
- Women were more likely to bring newborns to well-baby visits.
- Women used more effective forms of birth control, i.e. a long-acting reversible contraceptive (LARC) method rather than only a condom.
Maslowsky and her colleagues were thrilled with the results. “Our Ecuadorian collaborators are enthusiastic about the potential of this intervention to improve postpartum maternal and infant health,” Maslowsky said.
“We are planning the next phase of the study: universal implementation of this program for all new mothers in one of southern Quito’s health zones, which has a population of more than 400,000,” Maslowsky says.
In 11 years, Maslowsky has traveled to Quito more than a dozen times. In a trip this spring, she was joined by Ric Bonnell, director of Global Health Programs in the Dell Medical School’s Department of Population Health program. They are exploring potential partnerships for Dell with Maslowsky’s program in Ecuador.
