Background Mobile health interventions have emerged as a promising strategy in the global effort to enhance maternal and newborn care practices. In this study, we aimed to develop and test a context-tailored short message service (SMS)-integrated web-based application to improve maternal and newborn health in Ethiopia. Methods We conducted a system development and pilot usability testing study. We followed the stages of the waterfall model. Initially, we collected and systematically analyzed requirements from stakeholders to understand the desired outcomes of the application. During the development phase, we wrote the code to build application components, modules, and features. Finally, we tested the application through unit, prototype, and pilot testing to identify and resolve any defects before deployment. Result The system sends 78 key messages to pregnant women between 16 and 20 weeks of gestation, covering 10 thematic areas during pilot testing. The application features an interface for scheduling and automatically tailoring text messages based on the last menstruation period. Message delivery success was 97.4%, security and privacy features functioned at 100%, and network connectivity resilience was 98% in field simulations. User requirements and acceptability were evaluated through pilot testing with healthcare providers and end users, with high endorsement for message dispatch flexibility (96.4%) and distinct messaging features (92.9%). Usability test yielded a mean score of 92.3. Conclusion The application has been successfully developed and tested. It offers organized SMS scheduling and effectively tailors messages based on the pregnant mother's last menstruation period. The system provides timely health information, tracking pregnancies, facilitating remote consultations, and connecting women with local support groups. These findings indicate that mobile health is a viable strategy for improving maternal and newborn health. Trial registration Clinical trials PACTR202201753436676, 4 January 2022.
Bulcha et al. (Thu,) studied this question.