With the app usage and FGDs, it is plausible to say that the piloting of the app was successful with free Internet access because of the high continuing rate, increase in mini-quiz scores, and positive comments from midwives. Based on the FGDs, all of the midwives expressed their satisfaction with the app, with important elements including comprehensive contents, feelings of confidence, and reciprocal communication of the app. Similarly, Birkmeyer et al.
In the review, one study that found that the app was not effective attributed this finding to the app’s lack of interactive features . Although the app in this study was not created for healthcare providers rather than for patients or pregnant women, the results overlapped with the mHealth studies for patients. Regardless, it is important to consider how users interact with content and with other users.
It is necessary to arrange the environment so that midwives feel comfortable using the app, such as using a poster to inform patients that midwives may use their smartphone for their job. It is also key to prepare stable and free Internet access. In a scoping review of telehealth during COVID-19 [], the authors noted that no study was published from Africa on this topic. Other low- to upper-middle-income countries already have some telehealth-related infrastructure in place.
To further discuss the results of the BPQ, it is interesting to find that only knowledge and a subscale of home-based value showed significant differences between the groups. Using this app, it is easier to increase knowledge on subjects such as danger signs and birth preparedness. Several studies have shown an increase in knowledge through mHealth interventions [
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