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

November 5, 2026 updated by: Joseph Opeolu Ashaolu, Duy Tan University

Voice-Based vs. Text-Based WhatsApp Messaging for Maternal Health Knowledge and Attitudes Among Pregnant and Breastfeeding Women in Abuja, Nigeria: A Three-Arm Pilot Randomized Controlled Trial

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.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

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.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
79

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

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

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Description

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 informed consent.

Exclusion Criteria:

Inability to provide informed consent.

Any medical condition precluding participation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
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

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.
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

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.
No Intervention: Standard Care

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

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Maternal Health Knowledge Score (Scale b2)
Time Frame: Baseline (T0) and 8-week follow-up (T2)

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).
Baseline (T0) and 8-week follow-up (T2)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Duy Tan University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
May 10, 2026

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 20, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 10, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 5, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 5, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 10, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 10, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 5, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • MIVA/REC/2026/0042
  • MIVA/REC/2026/0042 (Registry Identifier: MIVA Open University Research Ethics Committee)
  • MIVA/REC/2026/0042 (Other Identifier: MIVA Open University)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

IPD Sharing Supporting Information Type

  • SAP
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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