Does mobile phone ownership predict better utilization of maternal and newborn health services? a cross-sectional study in Timor-Leste


Socio-demographic characteristics, mobile phone ownership, and selected maternal and newborn health services were characterized using descriptive statistics. We included demographic characteristics (age, years of schooling, household commodities, materials of the roof and floor, literacy), number of births, number of children, and travel time to the nearest health facility in the analysis. Household ownership of mobile phones was the exposure variable of interest. We coded our exposure variable as mobile phone owners and on-mobile phone owners, defined as women who did or did not have access to a mobile phone in their household. Outcome variables included ANC4+ (defined as had antenatal care visits four or more times during last pregnancy), SBA (had a skilled birth attendant, such as a midwife or a doctor, deliver their last baby), health facility delivery (delivered their last baby at a health facility), early postnatal care (had a postnatal checkup by a health worker within 24 h after delivery either at a health facility, home or other location), and early neonatal care (had their newborn baby checked by a health worker within 24 h after the baby was born).

Original continuous data such as age, years of school, number of children, and travel time to the nearest health facility were classified into categories. Based on the methods introduced in DHS [2629], we calculated the wealth index by compositely measuring the cumulative living standards based on household assets: electricity, radio, television, bicycle, car or truck, horse or other animal powered transport, type of roofing, and type of flooring. Principal Component Analysis (PCA) was applied to assess the factor weight of each asset. The wealth index, which is a continuous variable, was then divided into five indices, which are Highest, Fourth, Middle, Second, and Lowest levels [29].