Perceptions of the influence of a mobile phone-based messaging platform on caregiver ECD knowledge, attitudes and practices: A qualitative exploration in an informal settlement in Nairobi

Abstract Background: Existing programs supporting initiatives for children younger than three years are inadequate and not accessible to many families, particularly in resource limited settings. Many primary caregivers have little knowledge on how to monitor the development of their children or the importance of engaging children in stimulative activities during the course of early development. Health system limitations make it difficult for health workers to educate and demonstrate stimulative engagement to caregivers. The massive use of technology can be used to facilitate access to growth and development programs for children. We developed and implemented a mobile phone technology to help caregivers monitor and stimulate their children’s development in real time. This study explored the influence that this intervention had on the caregivers’ early child development (ECD) knowledge, attitudes and practices. Methods: The qualitative study reported in this paper was from data collected within a larger mixed methods quasi-experimental study that examined the feasibility and effectiveness of a mobile phone platform on caregiver knowledge, attitudes, and practices (KAP) and ECD outcomes in a low income community in Nairobi. We conducted qualitative interviews through eight focus group discussions, three key informant interviews interviews and 9 indepth interviews among a total of 111 participants including primary caregivers (n=87), community health volunteers (CHVs)(n=21) health managers and workers (n=3) to determine their attitudes and experience with the intervention with regards to improving their KAP. Interviews were audio-recorded, transcribed, and analyzed thematically. Results: Caregivers and CHVs reported that the intervention had provided them with new knowledge that positively influenced their ECD caregiving attitudes and practices. CHVs and health workers and managers reported that the intervention had provided caregivers with confidence in caring for their children while increasing their knowledge on how to monitor and stimulate their childrens development. Conclusion: Mobile phone technology can be effectively used to enhance caregivers’ knowledge of ECD and enable them to monitor and support their children’s development in real time. Trial registration: The trial was registered with the Pan African Clinical Trial Registry (www.pactr.org) database (ID number: PACTR201905787868050)