Bossman Elvis, Johansen Monika A, Zanaboni Paolo
Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
Front Glob Womens Health. 2022 Aug 25;3:942146. doi: 10.3389/fgwh.2022.942146. eCollection 2022.
Reducing maternal mortality, neonatal mortality and under 5-year mortality are important targets addressed by the United Nations' Sustainable Development Goals. Despite studies reported an improvement in maternal and child health indicators, the progress achieved is not uniform across regions. Due to the increasing availability of mobile phones in low and middle-income countries, mHealth could impact considerably on reducing maternal and child mortality and maximizing women's access to quality care, from the antenatal stage to the post-natal period.
A systematic literature review of mHealth interventions aimed at reducing maternal and child mortality in Sub-Saharan Africa and Southern Asia. Primary outcomes were maternal mortality, neonatal mortality, and under-five mortality. Secondary outcomes were skilled birth attendance, antenatal care (ANC) and post-natal care (PNC) attendance, and vaccination/immunization coverage. We searched for articles published from January 2010 to December 2020 in Embase, Medline and Web of Science. Quantitative comparative studies were included. The protocol was developed according to the PRISMA Checklist and published in PROSPERO [CRD42019109434]. The Quality Assessment Tool for Quantitative Studies was used to assess the quality of the eligible studies.
23 studies were included in the review, 16 undertaken in Sub-Saharan Africa and 7 in Southern Asia. Most studies used SMS or voice message reminders for education purposes. Only two studies reported outcomes on neonatal mortality, with positive results. None of the studies reported results on maternal mortality or under-five mortality. Outcomes on skilled birth attendance, ANC attendance, PNC attendance, and vaccination coverage were reported in six, six, five, and eleven studies, respectively. Most of these studies showed a positive impact of mHealth interventions on the secondary outcomes.
Simple mHealth educational interventions based on SMS and voice message reminders are effective at supporting behavior change of pregnant women and training of health workers, thus improving ANC and PNC attendance, vaccination coverage and skilled birth attendance. Higher quality studies addressing the role of mHealth in reducing maternal and child mortality in resource-limited settings are needed, especially in Southern Asia.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019109434, identifier CRD42019109434.
降低孕产妇死亡率、新生儿死亡率和5岁以下儿童死亡率是联合国可持续发展目标所涉及的重要目标。尽管有研究报告称孕产妇和儿童健康指标有所改善，但各地区取得的进展并不一致。由于中低收入国家手机的普及程度不断提高，移动健康（mHealth）可能会对降低孕产妇和儿童死亡率以及使妇女从产前到产后都能最大限度地获得优质护理产生重大影响。
对旨在降低撒哈拉以南非洲和南亚孕产妇和儿童死亡率的移动健康干预措施进行系统的文献综述。主要结果是孕产妇死亡率、新生儿死亡率和5岁以下儿童死亡率。次要结果是熟练接生、产前护理（ANC）和产后护理（PNC）的参与情况以及疫苗接种/免疫覆盖率。我们检索了2010年1月至2020年12月在Embase、Medline和科学网发表的文章。纳入定量比较研究。该方案根据PRISMA清单制定，并发表在PROSPERO上[CRD42019109434]。定量研究质量评估工具用于评估符合条件的研究的质量。
该综述纳入了23项研究，其中16项在撒哈拉以南非洲进行，7项在南亚进行。大多数研究使用短信或语音消息提醒进行教育。只有两项研究报告了新生儿死亡率的结果，结果为阳性。没有研究报告孕产妇死亡率或5岁以下儿童死亡率的结果。分别有6项、6项、5项和11项研究报告了熟练接生、产前护理参与、产后护理参与和疫苗接种覆盖率的结果。这些研究中的大多数都显示了移动健康干预对次要结果的积极影响。
基于短信和语音消息提醒的简单移动健康教育干预措施在支持孕妇行为改变和培训卫生工作者方面是有效的，从而提高了产前护理和产后护理的参与率、疫苗接种覆盖率和熟练接生率。需要开展更高质量的研究，以探讨移动健康在资源有限环境中降低孕产妇和儿童死亡率方面的作用，特别是在南亚。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019109434，标识符CRD42019109434。
