title: Does mobile phone ownership predict better utilization of maternal and newborn health services? a cross-sectional study in Timor-Leste.
abstract: Increasingly popular mobile health (mHealth) programs have been proposed to promote better utilization of maternal, newborn and child health services. However, women who lack access to a mobile phone are often left out of both mHealth programs and research. In this study, we determine whether household mobile phone ownership is an independent predictor of utilization of maternal and newborn health services in Timor-Leste.
  
  
  
  The study included 581 women aged 15-49 years with a child under the age of two years from the districts of Manufahi and Ainaro in Timor-Leste. Participants were interviewed via a structured survey of knowledge, practices, and coverage of maternal and child health services, with additional questions related to ownership and utilization of mobile phones. Mobile phone ownership was the exposure variable, and the dependent variables included having at least four antenatal care visits, skilled birth attendance, health facility delivery, a postnatal checkup within 24 h, and a neonatal checkup within 24 h for their youngest child. Logistic regression models were applied to assess for associations.
  
  
  
  Sixty-seven percent of women reported having at least one mobile phone in the family. Women who had a mobile phone were significantly more likely to be of higher socioeconomic status and to utilize maternal and newborn health services. However, after adjusting socioeconomic factors, household mobile phone ownership was not independently associated with any of the dependent variables.
  
  
  
  Evaluations of the effects of mHealth programs on health in a population need to consider the likelihood of socioeconomic differentials indicated by mobile phone ownership.
authors.affiliation: School of Public Health, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.|Sun Yat-sen Global Health Institute, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.|Department of Global Health, University of Washington, 1510 N.E. San Juan Road, Seattle, WA, 98195-7965, USA.|Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA, 98105, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Nie
authors.affiliation: Department of Global Health, University of Washington, 1510 N.E. San Juan Road, Seattle, WA, 98195-7965, USA.|Department of Obstetrics & Gynecology, University of Washington, Harborview Medical Center, 325 Ninth Ave, Box 359865, Seattle, WA, 98104, USA.
authors.forename: Jennifer Anna
authors.initials: JA
authors.lastname: Unger
authors.affiliation: Department of Global Health, University of Washington, 1510 N.E. San Juan Road, Seattle, WA, 98195-7965, USA.|Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA, 98105, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Thompson
authors.affiliation: Department of Global Health, University of Washington, 1510 N.E. San Juan Road, Seattle, WA, 98195-7965, USA.
authors.forename: Marisa
authors.initials: M
authors.lastname: Hofstee
authors.affiliation: School of Public Health, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China. gujing5@mail.sysu.edu.cn.|Sun Yat-sen Global Health Institute, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China. gujing5@mail.sysu.edu.cn.
authors.forename: Jing
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Global Health, University of Washington, 1510 N.E. San Juan Road, Seattle, WA, 98195-7965, USA.|Health Alliance International, 1107 NE 45th Street, Suite 350, Seattle, WA, 98105, USA.
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Mercer
mesh_terms: D000293:Adolescent; D000328:Adult; D040421:Cell Phone; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000068101:Maternal-Child Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010067:Ownership; D011181:Postnatal Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D049648:Timor-Leste; D055815:Young Adult
keywords: Health services; Maternal, newborn, and child health; Mobile phone ownership; mHealth