Community-based Digital Support Using Two-Way SMS to Improve Newborn Health and Reduce Neonatal Death in Western Kenya

What this Trial Is About

Neonatal mortality, defined as death within the first 28 days of life, remains very high in sub-Saharan Africa, including Kenya where about 40,000 neonatal deaths occur yearly. This trial evaluates a two-way interactive SMS messaging program, called CHV-NEO, designed to improve communication between mothers and community health volunteers CHVs during the critical early weeks after birth. The study is a cluster-randomized control trial conducted in Western Kenya to assess whether this digital support can reduce neonatal deaths and improve newborn care. CHV-NEO integrates with an existing digital community health toolkit dCHT used by CHVs to manage their workflow and client visits. Mothers in the intervention group receive daily automated messages that guide them in recognizing danger signs in their newborns and allow real-time text communication with CHVs between monthly home visits. The control group continues with standard care, meaning CHVs provide usual monthly visits without the SMS support. This trial includes 20 facility clusters randomly assigned to either control or intervention. Participants will be pregnant women 26-36 weeks gestation who have daily mobile phone access and can read or have help reading messages in English, Kiswahili, or Luo. Researchers will track neonatal mortality up to 28 days after birth and assess newborn care practices like cord care, thermal care, breastfeeding initiation, and care-seeking behavior. Maternal knowledge of neonatal danger signs will also be measured. The study involves follow-up up to 6 weeks postpartum to monitor outcomes and acceptability of the SMS intervention.

CHV-NEO: Community-based Digital Communication to Support Neonatal Health