A randomized controlled trial of the impact of a family planning mHealth service on knowledge and use of contraception

Objectives: mHealth, or the use of mobile phones for health, is a promising but largely untested method for increasing family planning knowledge in developing countries. This study estimates the effect of m4RH, an mHealth service in Kenya that provides family planning information via text message, on consumers' knowledge and use of contraception.

Study design: We randomly assigned new consumers of the m4RH service to receive either full access or limited access to m4RH. We collected data on outcomes by sending questions directly to consumers via text message.

Results: Response rates to the text message surveys ranged from 51.8% to 13.5%. Despite relatively low response rates, response rates were very similar across the full-access and limited-access groups. We find that full access to m4RH increased consumers' scores on a test of contraceptive knowledge by 14% (95% confidence interval: 9.9%-18.2%) compared to a control group with limited access to m4RH. m4RH did not increase consumers' use of contraception, likelihood of discussing family planning with their partners, or likelihood of visiting a clinic to discuss family planning.

Conclusion: Text messages may increase family planning knowledge but do not, by themselves, lead to behavior change.

Implications: Text messages can be an effective method of increasing family planning knowledge but may be insufficient on their own to cause behavior change.