Published in PLOS One on 2025-12-17, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Jefferson Mwaisaka, John Ganle, Adom Manu, Kwasi Torpey
Source: PLOS One • DOI 10.1371/journal.pone.0320996
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Inefficient referral systems and limited awareness on the importance of antenatal care (ANC) hinder expectant adolescents and young women from achieving the recommended ANC visits. Mobile health interventions and community-based clinical outreaches have emerged as potential strategies to improve ANC utilization and skilled delivery rates.
This study evaluates the effectiveness of mHealth text messaging and community-based clinical outreaches in improving ANC uptake, skilled deliveries, and infants’ birthweights among expectant adolescents and young women in Kwale County, Coastal Kenya.
A quasi-experimental study was conducted across four public health facilities, comparing three groups: mHealth text messaging intervention, community-based outreaches, and a control group receiving standard care. Multivariate regression models were used to adjust for baseline differences and potential confounders. Key outcomes included ANC attendance, skilled birth attendance, and infant birthweights.
A total of 817 participants were included in the analysis. Participants in the mHealth (RR: 0.5 [95% CI: 0.4–0.7], p < 0.001) and outreach arms (RR: 0.1 [95% CI: 0.0–0.7], p = 0.024), had significantly lower risk of low ANC contacts compared to the control arm participants. Similarly, the odds of unskilled deliveries were significantly lower in the mHealth (OR: 0.2 [95% CI: 0.1–0.4, p < 0.001] and the outreach arms (OR: 0.1 [95% CI: 0.0–0.6], p = 0.007), compared to the control group. Notably, infants born to participants in the mHealth-text message intervention (OR: 5.9 [95% CI: 1.7–20.8, p = 0.006]) and outreach arms (OR: 6.6 [95% CI: 1.7–25.7], p = 0.007) had significantly higher odds of low birth weight, compared to those born to control arm participants.
Both mHealth-text messaging and community-based clinical outreaches can improve antenatal contacts and institutional skilled deliveries. Integrating both strategies can enhance maternal health outcomes for young women in Kenya and should be considered for broader adoption within public health programs to optimize care delivery.
Introduction
Each year, 2 million young girls aged 14 years and below and 21 million adolescent girls aged between 15–19 give birth in underdeveloped countries [1]. Around 27% of young women in the least developed nations between the ages of 20 and 24 give birth before age 18 with Sub-Saharan Africa recording the greatest rate of early childbearing [2]. In Kenya, an estimated 15% of girls aged 15–19 – approximately one in every seven are either pregnant or have given birth to their first child [3]. The rising number of pregnant teenagers is a public health quandary because most of them avoid skillful antenatal health services hence resulting to maternal problems and unfavorable health outcomes [4]. For instance, approximately 23.5% of adolescent mothers in Sub-Saharan Africa experience at least one adverse birth outcome, such as low birthweight, premature birth, or early neonatal mortality [5]. These adverse outcomes are significantly associated with low-quality antenatal care (ANC) [5]. The heightened risk of adverse birth outcomes among adolescent women is well-documented across various settings. In Kenya, the preterm birth rate among adolescent women was at one time reported at 5.6%, significantly higher than the 0.8% recorded among adult women [6]. Inadequate pregnant women’s uptake of well-timed and regular prenatal care is a critical obstacle for improving prenatal indicators, and specifically among expectant young women [7]. Additionally, there is enough scientific proof associating poor perinatal outcomes and other birth complications to inadequacy of ANC care among expectant adolescents and young women [4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2025 Jefferson Mwaisaka, John Ganle, Adom Manu, Kwasi Torpey. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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