Yadav Poonam, Kant Ravi, Kishore Surekha, Barnwal Shruti, Khapre Meenakshi
College of Nursing, All India Institute of Medical Sciences, Rishikesh, IND.
General Medicine, All India Institute of Medical Sciences, Rishikesh, IND.
Cureus. 2022 Jan 14;14(1):e21256. doi: 10.7759/cureus.21256. eCollection 2022 Jan.
Despite many efforts, the utilization of full antenatal and postnatal care remains a significant concern in low- and middle-income countries (LMICs). We planned to retrieve the relevant literature and pooled the data for meta-analysis to evaluate the impact of mobile health (mHealth) intervention on antenatal and postnatal care utilization in low- and middle-income countries. We searched the literature through major electronic databases such as PubMed, MEDLINE, Embase, Cochrane, Scopus, CINAHL, Clinical key, Google Scholar, and Ovid with selected keywords and explored the reference list of articles. Meta-analysis was performed using the RevMan software version 5.4; p-value < 0.05 was considered statistically significant. The effect of variables was measured in odds ratio (OR) with a fixed-effects model. Six published interventional studies were selected as per the eligibility and participants, intervention, comparison, and outcome (PICO) framed for systematic review and meta-analysis. The search was restricted to articles in the English language, articles published online, and preprinted articles until September 2020. Outcome variables include antenatal and postnatal care utilization by pregnant and delivered mothers. The results have been presented in the form of a forest plot. The findings of this meta-analysis depicted the significant increase in four or more antenatal care (ANC) attendance (OR = 1.81, 95% confidence interval (CI) = 1.49-2.19), tetanus toxoid (TT) immunization (OR = 1.63, 95% CI = 1.17-2.27), compliance to iron supplementation (OR = 1.88, 95% CI = 1.18-3.00), and postnatal care attendance (OR = 2.54, 95% CI = 2.15-2.99) among those pregnant mothers who received mHealth intervention compared with the control group. This meta-analysis creates evidence for the effectiveness of mHealth with pooled data of interventional studies with limited sample sizes. Technology is changing, but even with limited support such as short messaging service (SMS), there was an improvement in antenatal and postnatal service utilization. This meta-analysis concluded that mHealth has the potential to increase the utilization of antenatal and postnatal care compared to standard care, although the level of evidence is moderate.
尽管付出了诸多努力，但在低收入和中等收入国家（LMICs），充分利用产前和产后护理仍是一个重大问题。我们计划检索相关文献并汇总数据进行荟萃分析，以评估移动健康（mHealth）干预对低收入和中等收入国家产前和产后护理利用情况的影响。我们通过PubMed、MEDLINE、Embase、Cochrane、Scopus、CINAHL、Clinical key、Google Scholar和Ovid等主要电子数据库，使用选定的关键词进行文献检索，并查阅文章的参考文献列表。使用RevMan 5.4软件进行荟萃分析；p值<0.05被认为具有统计学意义。变量的效应采用固定效应模型以比值比（OR）进行衡量。根据为系统评价和荟萃分析制定的合格标准及参与者、干预措施、对照和结局（PICO），选择了六项已发表的干预性研究。检索限于2020年9月之前发表的英文文章、在线发表的文章和预印文章。结局变量包括怀孕和分娩母亲的产前和产后护理利用情况。结果以森林图的形式呈现。这项荟萃分析表明，与对照组相比，接受mHealth干预的孕妇在四次或更多次产前检查（ANC）就诊率（OR = 1.81，95%置信区间（CI） = 1.49 - 2.19）、破伤风类毒素（TT）免疫接种率（OR = 1.63，95% CI = 1.17 - 2.27）、铁补充剂依从性（OR = 1.88，95% CI = 1.18 - 3.00）和产后检查就诊率（OR = 2.54，95% CI = 2.15 - 2.99）方面均有显著提高。这项荟萃分析通过样本量有限的干预性研究汇总数据，为mHealth的有效性提供了证据。技术在不断变化，但即使在诸如短信服务（SMS）等有限支持下，产前和产后服务的利用情况也有所改善。这项荟萃分析得出结论，尽管证据水平中等，但与标准护理相比，mHealth有潜力提高产前和产后护理的利用率。
