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

Completed

Conditions

Intervention / Treatment

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

Interventional

Enrollment (Actual)

79

Phase

  • 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

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
Intervention / Treatment
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

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

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)

May 10, 2026

Primary Completion (Actual)

August 20, 2026

Study Completion (Actual)

September 10, 2026

Study Registration Dates

First Submitted

November 5, 2026

First Submitted That Met QC Criteria

November 5, 2026

First Posted (Actual)

November 10, 2026

Study Record Updates

Last Update Posted (Actual)

November 10, 2026

Last Update Submitted That Met QC Criteria

November 5, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Other Study ID 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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