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Background   Aponjon  (meaning “near and dear ones”), a mobile phone-based mHealth service, customized voice messages for expectant (6–42 weeks pregnancy) and new mothers (1–52 weeks after delivery) for promotion of recommended healthcare practices. The  Aponjon  system sent two voice messages per week to subscribers, tailored to the timing during pregnancy or post-partum. The current study is an external evaluation of the effect of  Aponjon  use on knowledge and behaviors related to maternal and newborn health (MNH) care.    Methods  We implemented an observational study of  Aponjon  users with propensity score matched non-users in Bangladesh. Subscribers with at least 3 months exposure to  Aponjon  and non-users were interviewed retrospectively on knowledge and practices surrounding MNH. The sample included women with infants ≤6 months (243 users; 369 non-user) for maternal health knowledge and practice indicators and women with infants > 6 to 12 months old (332 users; 454 non-user) for neonatal health knowledge and practice indicators. Data were analyzed using principal component analysis and categorized as ‘high’ and ‘low’ at the median of principal component scores. Interactions between duration of use of  Aponjon  services and self-reported patterns of receiving and listening to messages were examined to assess the effect on knowledge and practices for MNH.    Results  Women reporting at least 6 months of using  Aponjon  were approximately 3 times as likely as the non-users to score high on both maternal healthcare knowledge questions and related practices. Similarly women with at least 6 months of  Aponjon  exposure were 1.5 times as likely as the non-users to score high on knowledge questions on newborn health. Reporting a good-pattern of  Aponjon  use (i.e. receiving a minimum of 3 messages per month and listening to all of them) had an even stronger association with knowledge and practices related to MNH care. However, a shorter exposure to Aponjon service (i.e. 3–5 months), despite having a good-pattern of use, did not have an effect on the related outcomes.    Conclusions  The use of  Aponjon  services for at least 6 months, with a good-pattern of receiving and listening to the messages, was associated with improved knowledge and practices related to MNH care.    Electronic supplementary material  The online version of this article (10.1186/s12911-019-0903-z) contains supplementary material, which is available to authorized users.

Does mHealth voice messaging work for improving knowledge and practice of maternal and newborn healthcare?