The extent of exposure to mobile health initiatives in promoting timely initiation of antenatal care among pregnant women living with HIV in Kamuli district. A cross-sectional study
Résumé
Background: Timely initiation of antenatal care (ANC) is essential for improving maternal and neonatal outcomes, particularly among pregnant women living with HIV (PWLHIV). This study assessed the extent of exposure to mHealth initiatives in promoting timely ANC initiation among PWLHIV in Kamuli District, Uganda. Methodology: A cross-sectional phenomenological qualitative study was conducted in Kamuli District among pregnant women living with HIV and health workers implementing mHealth interventions. Purposive sampling was used to select 15 pregnant women and 5 key informants. Data were collected using in-depth interviews and key informant interviews. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed using Atlas.ti version 13. Ethical approval and informed consent were obtained before data collection. Results: The majority were farmers/peasants (35%), housewives (30%), and small business owners (25%). Most respondents were Catholic (30%), while 40% had attained primary education. Exposure to mHealth initiatives was moderate but unequal. Awareness mainly came through health workers, radio programs, and peers. Participants reported receiving ANC appointment reminders, medication alerts, and HIV-related education through mobile phones, which encouraged earlier ANC attendance. Health worker recommendations increased trust and willingness to use mHealth services. However, barriers included poor network connectivity, limited phone ownership, low digital literacy, privacy concerns, and inconsistent or excessive messaging. Women in remote rural areas were less exposed than those living near health facilities. Conclusion: Exposure to mHealth initiatives positively contributes to the timely initiation of ANC among PWLHIV in Kamuli District by improving reminders, awareness, and access to HIV-related maternal health information. However, access remains uneven due to technological and social barriers. Recommendation: Government and partners should strengthen rural network coverage, increase community sensitization, train health workers in digital support, ensure confidentiality, and design simple SMS-based interventions tailored to women with low literacy levels.
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