Utilization of maternal health care services and ownership and use of mobile phones among Indian women

Background: Even with years of maternal and child health programmes and interventions, maternal and child health issues persist in India. Given the expansion in the ownership and use of mobile phones, mobile health (mHealth) interventions have been designed and implemented to facilitate MCH services. This study aims to assess whether ownership and use of mobile phones by Indian women are associated with the utilization of maternal health indicators such as antenatal carevand institutional delivery services.Methods: This study used the latest publically available data on mobile phone use from a nationally representative household survey (n=12047) to examine the association between mobile phone ownership and use, such as access to the Internet or not, texting facility available on the phone or not with having at least four ANC visits or an institutional delivery. The data fitted survey-adjusted logistic regression models adjusted for women's autonomy, access to mass media, and other sociodemographic covariates.Results: Household ownership of a mobile phone was positively associated with receiving ANC (OR=1.21; CI=1.08-1.36) in fully adjusted models. Women with access to the Internet and SMS facility also had higher odds (OR=2.87; CI=1.54-5.34) of reporting an institutional delivery and receiving an ideal ANC (OR=1.25; CI=1.01-1.64) in the fully adjusted models Conclusions: Patriarchal social norms potentially affect women's use of mobile phones. mHealth based maternal and child health (MCH) interventions in India, particularly those targeting underprivileged/disadvantaged women, are unlikely to be effective unless measures are made to increase access to, and autonomy in, mobile phone use. Partnering with social scientists in designing such interventions and other policy-relevant implications are discussed.