BACKGROUND:
In Tanzania, reductions in maternal mortality highlight the need to improve quality of care. The World Health Organization promotes respectful maternity care and a midwifery model of care. However, challenges such as inadequate healthcare infrastructure, limited staff training, and healthcare provider overload persist. To address these issues, a mobile application was developed to empower women with electronic personal health data and streamline midwives’ documentation.

OBJECTIVES:
This study evaluated the effectiveness of a mobile application in enhancing women-centered care for pregnant women in Tanzania.

METHODS:
A cluster-randomized control trial was conducted in two healthcare facilities in Dar es Salaam, Tanzania during 2021-2022. Participants were pregnant women aged 16 or older, in their second trimester (14–28 weeks), and fluent in Swahili. Facilities were randomly assigned to the intervention or control group. The app provided pregnant women access to antenatal health records and educational materials, while midwives used the system to retrieve records and document antenatal checkups electronically. Women-centered care was assessed using the 23-item WCC English version questionnaire (WCC23E). Effects of the intervention on women-centered care were evaluated with general linear regression models. Ethical clearance was obtained from Hiroshima University Clinical Research Ethics Committee (C-340) and the National Institute of Medical Research in Tanzania (NIMR/HQ/R.8a/Vol.IX/1604).

RESULTS:
The intervention group showed significantly higher WCC23E scores than the control group at follow-up (mean difference: 32.54, 95% CI: 30.93–34.16). This change remained significant after adjusting for age, parity, and baseline scores (mean difference: 32.42, 95% CI: 30.71–34.13), and other covariates (mean difference: 32.45, 95%CI: 30.44-34.46).

CONCLUSIONS:
The mobile application effectively improved women-centered care, highlighting its potential to enhance midwifery care in Tanzania.

KEY MESSAGE:
The mobile application empowered women with personal health data while reducing midwives' documentation burden. Scaling up mobile health solutions could enhance respectful and women-centered care globally. Digital technology/AI 1 (including three-minute presentation competition)