Assessment of Effect of Mobile-Linked Health Intervention on Health literacy of Pregnant Women in Cholistan Desert, Punjab, Pakistan

Background

Maternal health during pregnancy is critical for favorable maternal and neonatal outcomes. However, women living in remote and resource-limited regions face persistent barriers in accessing timely health information and care. In the Cholistan Desert of Punjab, Pakistan, geographic isolation, limited health infrastructure, low literacy levels, and deeply rooted cultural practices contribute to poor maternal nutrition and a high prevalence of anemia. Mobile health (mHealth) interventions offer a promising approach to address these gaps by enabling low-cost, direct communication with pregnant women.

Methods

This randomized controlled trial assessed the impact of a real-world WhatsApp-based mHealth intervention on maternal health literacy, nutritional status, dietary behaviors, and predictors of anemia among 384 pregnant women recruited from three public-sector health facilities in the Bahawalpur, Bahawalnagar, and Rahim Yar Khan districts. WhatsApp was selected due to its widespread use, familiarity, and minimal technical requirements in low-resource settings. Participants were randomly assigned to an intervention group receiving structured, interactive maternal health support via WhatsApp or a control group receiving routine antenatal care. Data were collected using structured questionnaires adapted from validated tools and standard nutritional assessments. Questionnaires were administered physically in the health care facility in the control group and in the intervention group before and after intervention.

Results

Women in the intervention group demonstrated significant improvements in nutrition-related knowledge, maternal health awareness, dietary practices, and key anemia-related indicators compared with the control group. Positive changes were also observed in selected mental and social well-being indicators. Implementation challenges included limited digital literacy, intermittent mobile connectivity, skepticism toward technology-based health advice, and continued reliance on traditional practices, which affected engagement among some participants.

Conclusion

This study provides evidence that a WhatsApp-based, real-world mHealth intervention can improve maternal health literacy, nutritional behaviors, and anemia-related outcomes in marginalized desert communities. Using familiar platforms enhances feasibility, acceptability, and program scalability.