Table 1.

Summary of findings.

Stages of appropriation	Enablers	Hindrances
Level 1: adoption	Easy to use [23,26,27,31,35]; content in local languages [23,24,35]; able to access the intervention on any mobile phone [13,30,31,35]; use of methods familiar to users (eg, SMS) [13,23,26,29,33,36]; and clear messages [14,23,27,31-33]	Inconsistent network connection [23,24,28,31]; user timeouts [26,28]; mobile phone skills [31-33]; and low literacy levels [23,31-33,35]
Level 2: adaptation	New information learned [23,27,29,31-33,35]; trusting of the message [23,26,27,31,35,36]; convenience of the service [23,27,31-33,36]; able to share information with husbands and friends [23,31,33,34]; and able to get situation-specific advice [23,31,33]	Mobile numbers cannot be changed [29]; messages not delivered [23,29,32,33]; malfunction of the keypad or mobile phone [31,33]; call congestion [23,35]; and bottlenecks in voice messages [14,23]
Level 3: integration	Empowered in decision-making [27,31,33,35,36]; improved number of antenatal visits [13,23,27,31,35]; improved food and medicine consumption [27,31,36]; place of delivery (health facility) [14,23,27,31-33,35]; exclusive breastfeeding [23,27,29,31]; improved number of vaccines [23,26,27,31]; and improved number of postnatal visits [23,26,27,31]	Messages not useful [27-29]; miscarriage [23,28]; stillbirth [23,28]; and baby loss [23,28]