Table 10. Key messages.

Key Messages     • MfM improves CHWs’ perceptions of confidence and performance of maternal health related tasks by providing a systematic source for information delivery.     • CHWs’ experiences of training, support and utilization of mobile health technology are influenced by their age and education levels.     • mHealth interventions are limited in their impact on maternal health decision seeking as their effects are mediated by:     • Contextual factors such as the women’s responsibilities for the home, the need to arrange childcare during clinic visits or delivery and the positioning of men and mother-in-laws as key decision makers.     • Issues related to absence of adequate infrastructure related to transportation in rural areas proved to be a significant barrier in accessing care.     • In addition, it is essential that program developers consider contextual factors, such as those raised in our study, in the design of theory of change models as these could potentially influence outcomes and the achievement of mHealth intervention goals.