Perceived usefulness and satisfaction of pregnant women with a WhatsApp-based education intervention aiming to improve access to pregnancy care: a mixed-methods evaluation

Introduction Mobile health interventions are increasingly used to improve access to antenatal care (ANC), yet evidence on end-user usefulness and satisfaction is limited. This study evaluated the perceived usefulness and satisfaction of pregnant women with a WhatsApp-based education programme implemented in Yaoundé, Cameroon. Methods A mixed-methods sequential explanatory design was used. Participants’ enrolment was done through a purposive sampling for the qualitative component and through exhaustive sampling for the quantitative component of the study. Qualitatively, women participated in one-on-one interviews and data were analysed thematically. Quantitative data were collected through a structured questionnaire and analysed using descriptive and inferential statistics. Integration of findings followed the Pillar Integration Process. Results A total of 132 women were included in the quantitative study component while 12 accepted to participate in the one-on-one interviews. The perceived usefulness and satisfaction with the intervention mean score were 30.6, SD 4.5 (Scale 5–35) and 25.1, SD 1.7 (Scale 4–28), respectively. These scores were explained by the interviews: women emphasised reassurance from direct nurse interaction, better navigation of facility/laboratory schedules and the breadth and clarity of video lessons. Participants reported delays in the care provider’s response to their questions and frequent referrals to the health facility when they requested a medication prescription. Participants requested more frequent/diverse content and faster responses from care providers. In adjusted models, usefulness score was significantly higher in primiparous women compared with multiparous ones (p<0.001) and significantly lower among women with primary versus university education (p=0.019). No significant difference in satisfaction score was observed across sociodemographic, behavioural, psychosocial and health-related characteristics. Conclusions The WhatsApp-based education programme was perceived as useful and satisfactory for enhancing ANC engagement and knowledge. Optimising response timeliness and pre-enrolment orientation, and tailoring content for women with lower education and multiparous ones, could further strengthen impact and equity.