Adapted SMS4Dads service reports high engagement with new dads in Kenya
A successful father-support service developed in Australia has been used in a pilot study to test the feasibility of a text-only intervention for new dads in Kenya’s informal settlements.
SMS4baba was adapted from SMS4dads, pioneered by the University of Newcastle and evaluated between 2019 and 2022 with 72 Nairobi-based dads receiving three messages a week from late pregnancy until over six months post-partum.
The study reported high levels of engagement, according to results published on BMC Public Health – instilling knowledge, reinforcing positive parenting and helping fathers cope with the transition to fatherhood.
“SMS4baba’s acceptability was attributed to modest message frequency and utilising familiar language,” said the authors.
“Fathers reported examples of behaviour change in their parenting and spousal support, which challenged gendered parenting norms.”
The study confirmed that father-specific interventions using digital technologies were effective in reaching men from low-resource settings and that further exploration of text messaging channels targeting fathers to address family wellbeing in the perinatal period was warranted.
Globally, there has been little understanding of how to effectively recruit and engage fathers, and systematic reviews of interventions have found “limited attention to gender norms.”
The widespread use of mobile phones and mobile health technologies presented an opportunity for a different approach to deliver educational health information and support to low-resourced settings.
Mobile phone use in Kenya has increased considerably over recent years, with an estimated 65 million mobile phone cellular subscriptions in 2022, say the researchers.
“mHealth interventions may offer opportunities to communicate with fathers over the perinatal period to influence their understanding, and engagement in the care for their pregnant partners, and the developmental needs of infants and young children.”
The SMS4dads program was deemed suitable for adaptation given its digital method of delivery and its primary focus on supporting fathers transitioning into parenthood.
The intervention consists of a set of 173 brief text messages delivered to fathers’ mobile phones, with no end-user cost, from the 20th week of the pregnancy until the infant is 24 weeks of age. Message content addresses the fathers’ relationship with his baby, his relationship with and support of the baby’s mother, and his own self-care.
The intervention model aims to promote father-infant attachment and co-parenting, integrating components targeting couple relationships, and parent-child relationships. Most of the messages use ‘the voice’ of the baby to emphasise the fathers’ connection to the baby.
The original set of SMS4dads messages were translated to Swahili, one of the official languages in Kenya. Participants said they liked the messages because the content was educational and encouraging. One man said:
‘What I was happy about was the [messages] were written in an understandable and good language. I liked that…the messages were short and that was encouraging because when you have lengthy messages you may read and get to a point and get tired of reading.’
Another said:
‘What I liked was that even us men were included in the care of our children, because you see most of the times men are not included in [programmes] it is only women …’
The findings showed 80% retention over almost a one-year period. Based on participants’ self-reports, messages were consistently read and retained, and shared with others including spouses and males/peers.