Gender inequality is a pervasive societal challenge that affects far more areas of everyday life than most people realise. One research project, funded in part by the NRF, has revealed that this inequality even exists with mobile phone ownership, disproportionately affecting poor and rural women and impacting on issues related to healthcare. The results indicated that, among the effects of this inequality, is a negative impact on interventions designed to increase access to health information; improve patient-provider communication; influence the content and quality of health services received; and worsen health inequities of women and their families.

The research looked at the connection between phone ownership among women and care seeking and practices for reproductive maternal new-born and child health (RMNCH). The study analysed households and women’s access to phones and its effects on the RMNCH health outcomes in 15 countries, including South Africa, for which Demographic and Health Surveys data on phone ownership is available.

The study revealed that:

• Gender gaps in mobile phone ownership vary, but can be significant, with less than half of women owning mobile phones in countries such as Ethiopia, Malawi, Pakistan and Uganda.
• In 10 out of the 15 countries, rural women bear the brunt of the gender gap in mobile phone ownership much more than urban women. In addition, the gender gap in mobile phone ownership across income groups was significantly greater among poorer households than richer households
• Female phone ownership was generally associated with increased uptake of some RMNCH interventions. Females who owned mobile phones had higher prospects of improved reproductive and maternal healthcare including demand satisfaction for family planning, early antenatal care, antenatal care visits at least four times (4+), tetanus immunisation during pregnancy, skilled birth attendance, postnatal care (maternal and child), versus those without.
• In addition, among child health services, phone ownership among women was similarly associated with higher odds of postnatal care for newborns, vitamin A supplementation, and immunisations including tetanus and DTP3, measles and rotavirus. 

However, the research also highlighted a number of exceptions. For example, female mobile phone owners in the lowest income group were less likely to demand interventions such as family planning, immunisations for tetanus and DTP3, and vitamin A supplementation. The researchers argue that these findings are not surprising given that the programmes are often provided as part of campaigns or via community-based outreach, at little or no cost to users. In contrast, female phone owners in the higher income groups were more likely to receive interventions that require significant healthcare seeking such as antenatal care at least four times, skilled birth attendance and postnatal care for newborns, as compared with those in the low-income group.

The researchers suggest that further research and improvements in digital health metrics and data collection is needed to improve understanding of and devise strategies for addressing gaps in women’s ownership and use of mobile phones so that it effectively leads to improved utilisation of different RMNCH interventions.

Read the full paper published in BMJ Global Health  here.