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CompletedNCT07928401Updated Nov 10, 2026

Voice-Based vs. Text-Based WhatsApp Messaging for Maternal Health Knowledge and Attitudes Among Pregnant and Breastfeeding Women in Abuja, Nigeria

An interventional study of Participants received weekly maternal health audio messages delivered over eight weeks via a WhatsApp broadcast list. Message content was adapted from WHO and UNICEF maternal health education material in Maternal Health Literacy, sponsored by Duy Tan University. Completed at 1 site in Nigeria. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-11-10.

Sponsored by Duy Tan University · Not applicable, Interventional, and Health services research

From the registry’s dates

  • Registered 5 months after the study started (first participant enrolled May 2026, registered Nov 2026).
Updated Nov 10, 2026Newly registeredGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
79
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

This pilot randomized controlled trial aims to evaluate whether sending maternal health information via voice-based WhatsApp messages is more effective than text-based WhatsApp messages. The study enrolled 79 pregnant and breastfeeding women in Abuja, Nigeria, who were assigned to receive weekly voice messages, text messages, or standard care over an eight-week period. The primary goal is to determine if voice messaging produces greater improvements in maternal health knowledge and attitudes, which could offer a scalable, low-literacy-friendly tool to improve maternal health outcomes in Nigeria.

Read the detailed description

Maternal mortality remains unacceptably high in sub-Saharan Africa, and gaps in maternal health knowledge contribute to delayed care-seeking behavior. While mobile health (mHealth) interventions offer scalable solutions, evidence directly comparing voice-based and text-based delivery formats in African settings is lacking.

This three-arm pilot randomized controlled trial was designed to address this gap by evaluating the preliminary effectiveness of voice-based versus text-based WhatsApp messaging on maternal health knowledge and attitudes. The theoretical rationale for the intervention is grounded in media richness and social presence frameworks, which suggest that voice communication conveys paralinguistic cues and creates greater social presence than text alone, potentially reducing cognitive load for women with limited literacy.

Participants were randomized into three arms: voice-based WhatsApp messaging, text-based WhatsApp messaging, or a standard care control group. The intervention consisted of weekly maternal health messages delivered over an eight-week period. The educational content, adapted from WHO and UNICEF maternal health materials, covered topics including nutrition, danger signs, breastfeeding, and postnatal care. Messages were delivered by a trained research assistant via a WhatsApp broadcast list, with the voice arm receiving audio recordings and the text arm receiving written messages of equivalent content.

The primary objective is to determine if voice-based messaging results in greater improvements in maternal health knowledge and attitudes compared to text-based messaging and standard care. Secondary exploratory objectives include assessing changes in a binary knowledge battery. The results of this pilot trial are intended to establish preliminary effect sizes and inform the design of a definitive, multi-site randomized controlled trial to evaluate voice messaging at scale.

02

Conditions studied

  • Maternal Health Literacy

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03

In context

Literacy

201 studies on the registry are indexed under Literacy; 69 are open to participants now.

This study's enrollment of 79 is below the median of 124 across 170 interventional studies indexed under Literacy.

Browse Literacy studies →

Lead sponsor

This is the only study on the registry with Duy Tan University as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Pregnant or breastfeeding women attending Kuchingoro Primary Health Care Centre.

Own a mobile phone with WhatsApp capability.

Willing to receive health messages over an eight-week period.

Able to provide .

Exclusion criteria

Exclusion Criteria:

Inability to provide .

Any medical condition precluding participation.

Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
79 participants (actual)

Study arms

  • Experimental
    Voice-Based Messaging

    Participants received weekly maternal health audio messages via WhatsApp for eight weeks.

    Behavioral: Participants received weekly maternal health audio messages delivered over eight weeks via a WhatsApp broadcast list. Message content was adapted from WHO and UNICEF maternal health education material

  • Active comparator
    Text-Based Messaging

    Participants received weekly maternal health text messages via WhatsApp for eight weeks.

    Behavioral: Participants received weekly maternal health audio messages delivered over eight weeks via a WhatsApp broadcast list. Message content was adapted from WHO and UNICEF maternal health education material

  • No intervention
    Standard Care

    Participants received standard routine care at the health facility without the WhatsApp messaging intervention

Interventions

  • BehavioralParticipants received weekly maternal health audio messages delivered over eight weeks via a WhatsApp broadcast list. Message content was adapted from WHO and UNICEF maternal health education material

    Participants received weekly maternal health written messages of equivalent content delivered over eight weeks via a WhatsApp broadcast list. Message content was adapted from WHO and UNICEF materials and covered nutrition, danger signs, breastfeeding, and postnatal care.

06

What researchers measure

Primary outcomes

  1. Maternal Health Knowledge Score (Scale b2)

    Assessed using a Likert-type scale (Scale b2) to measure maternal health knowledge. Internal consistency was acceptable (α = .78 at baseline, .81 at follow-up).

    Time frame: Baseline (T0) and 8-week follow-up (T2)

07

Study locations

1 site
  • Kuchingoro Primary Health Care Centre
    Abuja, Federal Capital Territory 11101, Nigeria
08

References and documents

Publications

  • Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, Patel V, Haines A. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med. 2013;10(1):e1001363. doi: 10.1371/journal.pmed.1001363. Epub 2013 Jan 15. PubMed 23458994 ↗

Individual participant data

Plan to share: Yes — The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Supporting information: Statistical analysis plan, Analytic code

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Nov 10, 2026
Show all 1 update
  1. Nov 10, 2026
    First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07928401
Lead sponsor
Duy Tan University
Responsible party
Joseph Opeolu Ashaolu (Dr, Duy Tan University) — Principal investigator
First posted
Nov 10, 2026
Start date
May 10, 2026
Primary completion
Aug 20, 2026
Completion
Sep 10, 2026
Last update
Nov 10, 2026

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2026. You cannot join it, but the record below documents what was studied.

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