School of Nursing, The Hong Kong Polytechnic University, Hong Kong S.A.R, China.
Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
BMC Health Serv Res. 2023 Jun 9;23(1):611. doi: 10.1186/s12913-023-09581-7.
Maternal mortality due to pregnancy, childbirth and postpartum is a global challenge. Particularly, in low-and lower-income countries, the outcomes of these complications are quite substantial. In recent years, studies exploring the effect of mobile health on the improvement of maternal health are increasing. However, the effect of this intervention on the improvement of institutional delivery and postnatal care utilization was not well analyzed systematically, particularly in low and lower-middle-income countries.
The main aim of this review was to assess the effect of mobile heath (mHealth) interventions on improving institutional delivery, postnatal care service uptake, knowledge of obstetric danger signs, and exclusive breastfeeding among women of low and lower-middle-income countries.
Common electronic databases like PubMed, EMBASE, the Web of Science, Medline, CINAHL, Cochrane library, Google scholar, and gray literature search engines like Google were used to search relevant articles. Articles that used interventional study designs and were conducted in low and lower-middle-income countries were included. Sixteen articles were included in the final systematic review and meta-analysis. Cochrane's risk of bias tool was used to assess the quality of included articles.
The overall outcome of the systematic review and meta-analysis showed that MHealth intervention has a positive significant effect in improving the institutional delivery (OR = 2.21 (95%CI: 1.69-2.89), postnatal care utilization (OR = 4.13 (95%CI: 1.90-8.97), and exclusive breastfeeding (OR = 2.25, (95%CI: 1.46-3.46). The intervention has also shown a positive effect in increasing the knowledge of obstetric danger signs. The subgroup analysis based on the intervention characteristics showed that there was no significant difference between the intervention and control groups based on the intervention characteristics for institutional delivery (P = 0.18) and postnatal care utilizations (P = 0.73).
The study has found out that mHealth intervention has a significant effect on improving facility delivery, postnatal care utilization, rate of exclusive breastfeeding, and knowledge of danger signs. There were also findings that reported contrary to the overall outcome which necessitates conducting further studies to enhance the generalizability of the effect of mHealth interventions on these outcomes.
妊娠、分娩和产后导致的孕产妇死亡是一个全球性挑战。特别是在低收入和中低收入国家，这些并发症的后果相当严重。近年来，探索移动医疗对改善孕产妇健康影响的研究越来越多。然而，这种干预措施对改善机构分娩和产后护理利用的效果并没有得到很好的系统分析，特别是在低收入和中低收入国家。
本综述的主要目的是评估移动医疗（mHealth）干预措施对改善低和中低收入国家妇女的机构分娩、产后护理服务利用、产科危险信号知识和纯母乳喂养的效果。
使用常见的电子数据库，如 PubMed、EMBASE、Web of Science、Medline、CINAHL、Cochrane 图书馆、Google Scholar 和灰色文献搜索引擎（如 Google）搜索相关文章。纳入使用干预性研究设计并在低和中低收入国家进行的文章。最终的系统评价和荟萃分析纳入了 16 篇文章。使用 Cochrane 偏倚风险工具评估纳入文章的质量。
系统评价和荟萃分析的总体结果表明，mHealth 干预措施对改善机构分娩（OR=2.21（95%CI：1.69-2.89）、产后护理利用（OR=4.13（95%CI：1.90-8.97）和纯母乳喂养（OR=2.25（95%CI：1.46-3.46）有积极的显著效果。该干预措施还显示出增加产科危险信号知识的积极效果。基于干预特征的亚组分析表明，基于干预特征的机构分娩（P=0.18）和产后护理利用（P=0.73）两组之间的干预与对照组之间没有显著差异。
研究发现，mHealth 干预措施对改善设施分娩、产后护理利用、纯母乳喂养率和危险信号知识有显著影响。也有与总体结果相反的发现，这需要进一步的研究来增强 mHealth 干预措施对这些结果的效果的普遍性。
