The Effectiveness of Family Planning Mobile Application and Enhanced Counseling on the Use of Modern Family Planning Methods Among Postpartum Women in Jordan.

Abstract

Introduction: To improve women's reproductive health and reproductive rights, appropriate interventions are needed to support family planning (FP) use during the postpartum period. Evidence on Arabic-language digital health interventions remains limited. This study aimed to assess the effect of enhanced counseling, alone and combined with an mHealth application, on modern FP method use among postpartum married women in Jordan.

Methods: A three-arm, parallel-group controlled trial with systematic individual allocation was conducted in six primary healthcare centers. Within each center, consecutively enrolled eligible women were assigned using a prespecified repeating 1:3:3 sequence to standard care, enhanced FP counseling, or enhanced counseling plus an Arabic-language mHealth application. Enhanced counseling was delivered by midwives who completed a five-day training workshop; the mHealth intervention provided FP information and 40 push notifications over the intervention period.

Results: At four months after baseline, 79.6% of women in the control group, 83.5% in the enhanced counseling group, and 96.9% in the enhanced counseling plus mHealth group reported using any FP method (p < 0.001). The corresponding proportions reporting use of a modern FP method were 17.2%, 49.7%, and 59.9%, respectively (p < 0.001). Compared with the control group, enhanced counseling was associated with substantially higher odds of modern FP methods use (aOR = 4.49; 95% CI: 3.05-6.62; p < 0.001) and higher odds of exclusive breastfeeding (aOR = 1.52; 95% CI: 1.09-2.13; p = 0.014), while the odds of using any FP method were not significantly different (aOR = 1.15; 95% CI: 0.77-1.73; p = 0.494). Enhanced counseling plus mHealth was associated with higher odds of any FP method use (aOR = 8.49; 95% CI: 4.72-15.28; p < 0.001), modern FP method use (aOR = 7.18; 95% CI: 4.85-10.63; p < 0.001), and exclusive breastfeeding (aOR = 2.49; 95% CI: 1.78-3.49; p < 0.001) compared with control.

Conclusion: Enhanced FP counseling, particularly when combined with the mHealth intervention, was associated with higher short-term uptake of modern FP methods among postpartum women. These findings support further evaluation of strengthened counseling and Arabic-language digital FP tools as components of routine maternal and child health services.