Acceptability and effect of ShishuPoshan mHealth application on knowledge, attitudes and practice of breastfeeding among primi mothers availing postnatal care at a rural tertiary hospital

ShishuPoshan is a free Android application for mothers that provides scientific guidance on breastfeeding and baby care issues in the local language. We aimed to assess its effect and acceptability in primi mothers in a rural area of Maharashtra, India. A before and after study was conducted in 50 primi mothers to study the acceptability and effect of ShishuPoshan mHealth application on knowledge, attitude and practice about breastfeeding in primi mothers in a rural tertiary care hospital. Most participants (84%) downloaded the application, and 60% used it regularly. Major reason for not using the app was discomfort with mobile phone (7%) and not having anyone to read the content in the house (7%). The application was easy to use by 48%, and 10% did not find time to use it. Enablers were regional language, easy-to-understand content, simple interface, and frequently asked question (FAQ) format to give information. Barriers to adoption were that women preferred tips from family members, were uncomfortable with mobile phones, and did not have anyone to help them use them. It successfully delivered key messages like exclusive breastfeeding, colostrum use, proper maternal nutrition, and demand to feed, but it needs to further emphasise early initiation of feeding. Incorporation of feedback like adding videos, myth busters, and making app more interactive may further improve its effectiveness. mHealth interventions like ShishuPoshan are promising modalities for the dissemination of appropriate information.