Access to and Use of Mobile Phone by Postpartum, Married Women in Punjab, India: Secondary Analysis of mHealth Intervention Pilot Data

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: As mobile phone uptake in India continues to grow, there is continued interest in mobile platform-based interventions for health education among other topics. Existing studies demonstrate a significant gender gap in mobile phone access, and suggest women’s access to mobile phones is constrained by economic and diverse social barriers. Pregnancy and postpartum care is one of many targets for mobile health (mHealth) interventions which particularly rely on women’s access to and facility with mobile phone use. Objective: This paper describes dynamics and patterns of women’s mobile phone access and use among both phone owners and non-owners, including potential barriers to mHealth participation. Methods: Mixed-methods data were obtained from two different surveys (n=102 and n=29), two sets of in-depth interviews (n=20 and 29), and weekly data collection obtained in preparation for or within the pilot of an mHealth postpartum care intervention in rural Punjab in July 2020-February 2021. Results: A majority of women owned their own phone, though about half (52%) of phone owners still reported sharing their phone with other family members. Sharing a phone with female family members typically allowed for better access than sharing with male family members. Some households have strict preferences against daughters-in-law having phones, or otherwise significantly restrict or control women’s phone access. Others reported concerns about phone use-related health hazards during pregnancy or postpartum for mother and infant. Conclusions: These findings suggest significant variability and nuance to what is meant by women’s phone ownership and access given the numerous additional constraints on their use of phones, particularly during pregnancy and postpartum. Future research and mHealth interventions should probe these domains to better understand these dynamics governing women’s access, use, and fluency with mobile phones to optimally design mHealth interventions. mHealth, mobile health, digital health, India, pregnancy, pregnant women, postpartum, postpartum care