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A digitally-enabled, stage-based community intervention for maternal and child health: Experimental evidence from rural China

Chen, Y.; Wu, Y.; Weber, A.; Medina, A.; Guo, Y.; Balakrishnan, S.; Zhang, H.; Zhou, H.; Rozelle, S.; Darmstadt, G. L.; Sylvia, S.

2026-03-30 public and global health
10.64898/2026.03.27.26349570 medRxiv
Show abstract

Comprehensive and responsive interventions are increasingly prioritized to address the diverse and evolving health challenges faced by mothers and children during the first 1,000 days of life. However, evidence remains limited on how such interventions can be operationalized in low-resource settings without overstretching frontline health workers. We developed a comprehensive yet flexible community-based intervention, the Healthy Future program, which integrates a stage-based maternal and child health curriculum with mHealth-enabled infrastructure to deliver targeted, stage-based support through home visits in low-resource settings. We evaluated its impact through a cluster-randomized controlled trial across 119 rural townships in China. The program demonstrated improvements across multiple health, behavioral, and intermediate outcomes, including young child feeding practices, caregiving knowledge, maternal mental health, and perceived social support. Overall, this study illustrates a move beyond stand-alone interventions toward a scalable, multidimensional delivery model capable of providing comprehensive, flexible, and timely support to mothers and children in low-resource communities while remaining feasible for large-scale implementation.

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