***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems . Antenatal care has the potential to reduce maternal morbidity and improve newborns ’ survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining . We evaluated the association between a mobile phone intervention and antenatal care in a re source -limited setting . We aim ed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during pregnancy . Methods This study was an open label pragmatic cluster-r and omised controlled trial with primary healthcare facilities in Zanzibar as the unit of r and omisation . 2550 pregnant women ( 1311 interventions and 1239 controls ) who attended antenatal care at selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery . 24 primary health care facilities in six districts were r and omized to either mobile phone intervention or st and ard care . The intervention consisted of a mobile phone text-message and voucher component . Primary outcome measure was four or more antenatal care visits during pregnancy . Secondary outcome measures were tetanus vaccination , preventive treatment for malaria , gestational age at last antenatal care visit , and antepartum referral . Results The mobile phone intervention was associated with an increase in antenatal care attendance . In the intervention group 44 % of the women received four or more antenatal care visits versus 31 % in the control group ( OR , 2.39 ; 95 % CI , 1.03 - 5.55 ) . There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although not statistically significant . Conclusions The  wired mothers ’ mobile phone intervention significantly increased the proportion of women receiving the recommended four antenatal care visits during pregnancy and there was a trend towards improved quality of care with more women receiving preventive health services , more women attending antenatal care late in pregnancy and more women with antepartum complications identified and referred . Mobile phone applications may contribute towards improved maternal and newborn health and should be considered by policy makers in re source -limited setting s . Trial registration Clinical Trials.gov , NCT01821222 In northern Nigeria , interventions are urgently needed to narrow the large gap between international breastfeeding recommendations and actual breastfeeding practice s. Studies of integrated microcredit and community health interventions documented success in modifying health behaviors but typically had uncontrolled design s. We conducted a cluster-r and omized controlled trial in Bauchi State , Nigeria , with the aim of increasing early breastfeeding initiation and exclusive breastfeeding among female microcredit clients . The intervention had 3 components . Trained credit officers led monthly breastfeeding learning sessions during regularly scheduled microcredit meetings for 10 mo . Text and voice messages were sent out weekly to a cell phone provided to small groups of microcredit clients ( 5 - 7 women ) . The small groups prepared songs or dramas about the messages and presented them at the monthly microcredit meetings . The control arm continued with the regular microcredit program . R and omization occurred at the level of the monthly meeting groups . Pregnant clients were recruited at baseline and interviewed again when their infants were aged ≥6 mo . Logistic regression models accounting for clustering were used to estimate the odds of performing recommended behaviors . Among the clients who completed the final survey ( n = 390 ) , the odds of exclusive breastfeeding to 6 mo ( OR : 2.4 ; 95 % CI : 1.4 , 4.0 ) and timely breastfeeding initiation ( OR : 2.6 ; 95 % CI : 1.6 , 4.1 ) were increased in the intervention vs. control arm . Delayed introduction of water explained most of the increase in exclusive breastfeeding among clients receiving the intervention . In conclusion , a breastfeeding promotion intervention integrated into microcredit increased the likelihood that women adopted recommended breastfeeding practice s. This intervention could be scaled up in Nigeria , where local organizations provide microcredit to > 500,000 clients . Furthermore , the intervention could be adopted more widely given that > 150 million women , many of childbearing age , are involved in microfinance globally Background Mobile phone technologies for health promotion and disease prevention have evolved rapidly , but few studies have tested the efficacy of mobile health in full-fledged programs . Text4baby is an example of mobile health based on behavioral theory , and it delivers text messages to traditionally underserved pregnant women and new mothers to change their health , health care beliefs , practice s , and behaviors in order to improve clinical outcomes . The purpose of this pilot evaluation study is to assess the efficacy of this text messaging campaign . Methods We conducted a r and omized pilot evaluation study . All participants were pregnant women first presenting for care at the Fairfax County , Virginia Health Department . We r and omized participants to enroll in text4baby and receive usual health care ( intervention ) , or continue simply to receive usual care ( control ) . We then conducted a 24-item survey by telephone of attitudes and behaviors related to text4baby . We surveyed participants at baseline , before text4baby was delivered to the intervention group , and at follow-up at approximately 28 weeks of baby ’s gestational age . Results We completed 123 baseline interviews in English and in Spanish . Overall , the sample was predominantly of Hispanic origin ( 79.7 % ) with an average age of 27.6 years . We completed 90 follow-up interviews , and achieved a 73 % retention rate . We used a logistic generalized estimating equation model to evaluate intervention effects on measured outcomes . We found a significant effect of text4baby intervention exposure on increased agreement with the attitude statement “ I am prepared to be a new mother ” ( OR = 2.73 , CI = 1.04 , 7.18 , p = 0.042 ) between baseline and follow-up . For those who had attained a high school education or greater , we observed a significantly higher overall agreement to attitudes against alcohol consumption during pregnancy ( OR = 2.80 , CI = 1.13 , 6.90 , p = 0.026 ) . We also observed a significant improvement of attitudes toward alcohol consumption from baseline to follow-up ( OR = 3.57 , CI = 1.13 – 11.24 , p = 0.029 ) . Conclusions This pilot study is the first r and omized evaluation of text4baby . It is a promising program in that exposure to the text messages was associated with changes in specific beliefs targeted by the messages Abstract Background Postpartum follow up of women who have been found to have gestational diabetes during pregnancy is essential because of the strong association of gestational diabetes with subsequent type 2 diabetes . Postal reminders have been shown to increase significantly attendance for oral glucose tolerance testing postpartum . It is possible that a short message service ( text ) reminder system may also be effective . This trial aims to assess whether a text message reminder system for women who have experienced gestational diabetes in their index pregnancy will increase attendance for oral glucose tolerance testing within six months after birth . Methods / Design Design : Single centre ( Women ’s and Children ’s Hospital , South Australia ) , parallel group r and omised controlled trial . Inclusion criteria : Women diagnosed with gestational diabetes in their index pregnancy ( oral glucose tolerance test with fasting glucose ≥ 5.5 mmol/L and /or two hour glucose ≥ 7.8 mmol/L ) , with access to a mobile phone , whose capillary blood glucose profile measurements prior to postnatal discharge are all normal ( fasting glucose < 6.0 mmol/L , postpr and ial glucoses < 8.0 mmol/L ) . Exclusion criteria : Pregestational diabetes mellitus , triplet/higher order multiple birth or stillbirth in the index pregnancy , requirement for interpreter . Trial entry and r and omisation : Allocation to intervention will be undertaken using a telephone r and omisation service ( computer-generated r and om number sequence generation , with balanced variable blocks , and stratification by insulin requirement ) . Study groups : Women in the intervention group will receive a text reminder to attend for an oral glucose tolerance test at 6 weeks postpartum , with further reminders at 3 months and 6 months if they do not respond to indicate test completion . Women in the control group will receive a single text message reminder at 6 months postpartum . Blinding : Baseline data collection will be undertaken blinded . Blinding of participants and blinded collection of primary outcome data will not be possible for this study . Primary study outcome : Attendance for the oral glucose tolerance test within 6 months postpartum . Sample size : 276 subjects will be required to show an 18 % absolute increase in the rate of attendance ( α=0.05 two tailed , β=80 % , 5 % loss to follow up ) from 37 % to 55 % in the intervention group . Discussion Given the heightened risk of impaired glucose tolerance and type 2 diabetes in women who have had gestational diabetes , ensuring the highest possible rate of attendance for postpartum glucose tolerance testing , so that early diagnosis and intervention can occur , is important . A text message reminder system may prove to be an effective method for achieving improved attendance for such testing . This r and omised controlled trial will assess whether such a system will increase rates of attendance for postpartum oral glucose tolerance testing in women who have experienced gestational diabetes . Trial Registration Australian New Zeal and Clinical Trials Registry - Background Although there are studies showing that mobile phone solutions can improve health service delivery outcomes in the developed world , there is little empirical evidence that demonstrates the impact of mHealth interventions on key maternal health outcomes in low income setting s. Methods A non-r and omized controlled study was conducted in the Amhara region , Ethiopia in 10 health facilities ( 5 intervention , 5 control ) together serving around 250,000 people . Health workers in the intervention group received an and roid phone ( 3 phones per facility ) loaded with an application that sends reminders for scheduled visits during antenatal care ( ANC ) , delivery and postnatal care ( PNC ) , and educational messages on dangers signs and common complaints during pregnancy . The intervention was developed at Addis Ababa University in Ethiopia . Primary outcomes were the percentage of women who had at least 4 ANC visits , institutional delivery and PNC visits at the health center after 12 months of implementation of the intervention . Findings Overall 933 and 1037 women were included in the cross-sectional surveys at baseline and at follow-up respectively . In addition , the medical records of 1224 women who had at least one antenatal care visit were followed in the longitudinal study . Women who had their ANC visit in the intervention health centers were significantly more likely to deliver their baby in the same health center compared to the control group ( 43.1 % versus 28.4 % ; Adjusted Odds Ratio ( AOR ) : 1.98 ( 95%CI 1.53–2.55 ) ) . A significantly higher percentage of women who had ANC in the intervention group had PNC in the same health center compared to the control health centers ( 41.2 % versus 21.1 % : AOR : 2.77 ( 95%CI 2.12–3.61 ) ) . Conclusions Our findings demonstrated that a locally customized mHealth application during ANC can significantly improve delivery and postnatal care service utilization possibly through positively influencing the behavior of health workers and their clients OBJECTIVE To pilot test the Text Reminders for Immunization Compliance in Kids ( TRICKs ) program to evaluate its feasibility and potential to increase immunization coverage . DESIGN R and omized controlled trial ( RCT ) . SETTING Pediatric clinic . PARTICIPANTS Parents of newborns being discharged from a local hospital who intended to seek child health care at the University-sponsored pediatric resident and faculty clinic . INTERVENTION Text message immunization reminders prior to immunization due date s. MAIN OUTCOME MEASURES Receipt and timeliness of immunizations at 2 , 4 and 6 months of age . RESULTS Participants ( N=90 ) were English ( 83 % ) or Spanish ( 17 % ) speaking . The majority were female ( 83 % ) , on public insurance ( 59 % ) , and had adequate health literacy ( 96 % ) . Parents were married or a member of an unmarried couple ( 62 % ) . Over 66 % had a high school diploma or less . Greater numbers of intervention children received immunizations and were " on time " using per protocol analysis ; though not statistically significance . Limitations include sample size , problematic text messaging software , and loss of phone service at 7 months for 40 % of intervention parents . However , post-intervention interviews ( N=18 ) indicated strong support for TRICKs ; 83 % found the text message reminders very helpful and 17 % somewhat helpful . DISCUSSION Pilot testing allowed us to assess processes , including recruitment , retention , and software , which will increase the success of an RCT . Software with built-in backup systems is needed for follow-up when mobile service is interrupted . However , in spite of limitations , immunization rates were higher in the text message reminder group , though not statistically significant . Parent support and interest was high . A fully powered RCT is needed with follow-up over the full 4 - 3 - 1 - 3 - 3 - 1 series . Based on our results , for 80 % power where we expected 90 % compliance in the intervention group and 80 % in the control group we need 219 per group , plus increases to address drop out and loss of follow-up Objective : Many sub-Saharan African countries report high postpartum loss to follow-up of mother – baby pairs . We aim ed to determine whether interactive text messages improved rates of clinic attendance and early infant HIV testing in the Nyanza region of Kenya . Design : Parallel-group , unblinded , r and omized controlled trial . Methods : HIV-positive pregnant women at least 1 
    Output:
    
Functions described in mHealth interventions were diverse , and the health stages covered were broad .
However , single function or single stage appeared to be dominant among mHealth interventions compared with multiple functions or stages .