Behaviour Change Communication Using Mobile Phones: Implications for Infant and Young Child Feeding Interventions
Authors: Mildon Alison , Sellen Daniel 
Published: November 2023

Background

Improving infant and young child feeding (IYCF) practices is critical to reducing the burden of preventable malnutrition, morbidity and mortality in low‐ and middle‐income countries (LMIC). Breastfeeding and complementary feeding practices can be improved through contextualized behaviour change communication (BCC), but access is limited. The proliferation of mobile phones in LMIC offers new opportunities for BCC delivery, with potential for large scale implementation. There is need for delivery science to determine how best to leverage mobile phones to support IYCF, and how to optimize the relevance and quality of such “mHealth” innovations.

Objectives

A scoping review was designed to identify and map current knowledge on IYCF BCC delivery using mobile phones, and to identify priorities for further research and programming.

Methods

Following the methodology proposed by Arksey & O'Malley (2005), we identified, extracted and synthesized data from searches of the published and grey literature, and consultation with mHealth researchers and implementers. We selected for analysis published articles and programmatic documents reporting on the feasibility, effectiveness or implementation lessons learned related to the use of mobile phones for BCC addressing maternal, newborn and child health (MNCH) practices in LMIC. We summarized, assessed and classified current evidence according to the main BCC delivery approach and the application of seven BCC techniques, based on the categories proposed by Briscoe & Aboud (2012).

Results

Seventeen published studies and nineteen grey literature reports met inclusion criteria, including eight effectiveness studies with at least one IYCF indicator. Four mobile phone‐based BCC delivery approaches were identified: direct messaging, job aid applications, voice counseling and interactive media. These approaches differ markedly in intervention intensity and utilization of interpersonal communication and problem solving support, two BCC techniques critical for improving IYCF. Individual trials of interventions using direct messaging, voice counseling or a combination have shown positive effects on exclusive breastfeeding. Mhealth approaches to deliver BCC addressing multiple MNCH topics have shown limited effects on IYCF practices, but the evidence base is small.

Conclusions

The four BCC delivery approaches can support interpersonal communication for improved IYCF practices in LMIC, but vary considerably in implementation elements. Both content development and selection of delivery approaches should be contextualized, guided by formative research. Interventions that explicitly target specific IYCF practices and emphasize personalized problem solving support are likely to be most effective. Further research on effectiveness, implementation pathways and cost‐effectiveness of specific BCC delivery approaches is needed.

Support or Funding Information

This work was carried out with the aid of a grant from the Micronutrient Initiative, Ottawa, Canada through the financial assistance of the Government of Canada through the Department of Foreign Affairs, Trade and Development Canada