Please select the eligibility criteria that correspond to the clinical trial below.
Title: Evaluation of an mHealth SMS Dialogue Strategy to Meet Women's and Couples' Postpartum Contraceptive Needs in Kenya
Brief Summary: Meeting women's need for postpartum family planning is has been acknowledged as a global priority in maternal and child health. The prevention of unintended pregnancies in sub-Saharan African countries, which carry the highest global burdens of maternal mortality and HIV infection, is projected to substantially decrease maternal and neonatal morbidity and mortality. Many barriers to contraceptive uptake exist, both within and outside of the postpartum time period, and include socio-cultural, economic, and supply-side factors. Furthermore, while the importance of engaging men in family planning programs has been acknowledged for decades, few interventions have succeeded in increasing male involvement in family planning while maintaining a focus on women's empowerment. Innovative approaches to meeting the family planning needs of women and couples are urgently needed.

Public health interventions are increasingly incorporating mobile health (mHealth) approaches using short message service (SMS) technology in low-income countries, approaches that have demonstrated benefit among various reproductive health outcomes. The investigators hypothesize that personalized, bidirectional SMS dialogue with individual women and couples will increase postpartum contraceptive uptake, thereby decreasing unmet need for family planning in Kenya. The investigators have collaborated with the University of Washington (UW) Department of Computer Science and Engineering (CSE) along with Kenyan telecommunication providers to develop a hybrid messaging system that allows for innovative bidirectional SMS messaging. This system has been used successfully in maternal child health (MCH) clinics in Kenya. In qualitative research, women in Kenya have expressed a strong desire for mHealth support to provide additional education, counseling and reminders to supplement counseling by health workers.

The investigators propose a randomized controlled trial (RCT) comparing the effects of bidirectional SMS dialogue vs. control on highly effective contraceptive use at 6 months postpartum among HIV negative women and couples in Nyanza Province, Kenya. Data from this RCT and accompanying qualitative study will contribute to innovative, scale-able strategies to address unmet need for contraception and increase male involvement in family planning.


Options:
A: Inclusion Criteria:

* Pregnant; at least 28 weeks gestation
* HIV negative
* Daily access to a mobile phone
* Planning to stay in area for 6 months postpartum
* Able to read/write or has trusted person to help

Exclusion Criteria:

* Does not meet above criteria
B: Inclusion Criteria:

* Aged 16-24
* Own a personal Android mobile phone
* Live in Tajikistan

Exclusion Criteria:

* Cannot read Tajik or Russian
C: Inclusion Criteria:

* HIV+ women starting ART
* Willing to be contacted by mobile phone
* Speaks English or Hindi or Kannada
* Screens positive for depressive symptoms or psychosocial risk factors
* Able to provide informed consent

Exclusion Criteria:

* Unable to participate in study visits
* Any condition that, in the opinion of the site investigator, would compromise the candidate's ability to participate
D: Inclusion Criteria:

* Received menstrual regulation services using Manual Vacuum Aspiration (MVA) or Medical Abortion (MA)
* Have a personal mobile telephone
* Agree to receive messages on mobile about family planning
* Provide informed consent for participation

Exclusion Criteria:

* Received anaesthesia for their MVA procedure
* Intend to become pregnant within the next six months
* Intend to use, or for partner to use, a permanent method of contraception (i.e. sterilisation) within the next six months

Answer: A