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中低收入国家产后母亲中数字健康与标准护理对纯母乳喂养持续时间的有效性:系统评价与荟萃分析

The effectiveness of digital health versus standard care on exclusive breastfeeding duration among postpartum mothers in LMIC: Systematic review and meta-analysis.

作者信息

Thepha Thiwawan, Carr Gillian, Marais Debbi, Kuasri Jatuporn, Klangphaow Kritsana, Tangpukdee Juraporn

机构信息

Department of Midwifery, Faculty of Nursing, Khonkaen University, Khonkaen, Thailand.

Masters of Public Health, University of Warwick, Coventry, UK.

出版信息

Digit Health. 2024 Dec 20;10:20552076241309520. doi: 10.1177/20552076241309520. eCollection 2024 Jan-Dec.

Abstract

OBJECTIVE

This study aims to evaluate the effectiveness of digital health interventions compared to standard care in promoting exclusive breastfeeding (EBF) among postpartum women in low-and middle-income countries (LMICs).

METHODS

The PRISMA guidelines of reporting were followed for the searching of four databases and screening following eligibility criteria: articles presenting digital health interventions, conducted as randomized control trials (RCTs), quasi-experimental, or mixed-method studies, reporting on EBF duration and early initiation of breastfeeding, and published in the English language were included.

RESULTS

Of 1595 articles screened, only 10 published between 2013 and 2023 met the criteria. Most studies were from Nigeria (n = 3), with others from Kenya, South Africa, Ethiopia, China, India, and Lebanon. Six were RCTs, and four were quasi-experimental. The meta-analysis shows digital health interventions significantly increase EBF duration, with the strongest effects at 6 months (odds ratio (OR) = 2,1.66-2.40), followed by 5, 3, 2, and 1 month postpartum, including the initial feed.

CONCLUSION

This suggests digital health interventions have the potential to enhance breastfeeding practices among postpartum mothers in LMICs. For future research, it is essential to consider accessibility, delivery intervention, healthcare professional collaboration, and the sustainable development of digital health interventions for postpartum mothers in LMICs.

摘要

目的

本研究旨在评估与标准护理相比,数字健康干预措施在促进低收入和中等收入国家(LMICs)产后妇女纯母乳喂养(EBF)方面的有效性。

方法

遵循PRISMA报告指南检索四个数据库,并根据纳入标准进行筛选:纳入呈现数字健康干预措施的文章,这些文章以随机对照试验(RCT)、准实验或混合方法研究的形式开展,报告纯母乳喂养持续时间和母乳喂养的早期开始情况,且以英文发表。

结果

在筛选的1595篇文章中,只有2013年至2023年发表的10篇文章符合标准。大多数研究来自尼日利亚(n = 3),其他研究来自肯尼亚、南非、埃塞俄比亚、中国、印度和黎巴嫩。六项为随机对照试验,四项为准实验。荟萃分析表明,数字健康干预措施显著增加了纯母乳喂养的持续时间,在6个月时效果最强(优势比(OR)= 2.16 - 2.40),其次是产后5个月、3个月、2个月和1个月,包括首次喂养。

结论

这表明数字健康干预措施有可能改善低收入和中等收入国家产后母亲的母乳喂养行为。对于未来的研究,必须考虑数字健康干预措施对低收入和中等收入国家产后母亲的可及性、实施干预、医疗保健专业人员合作以及可持续发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ae1/11662382/247f8788f453/10.1177_20552076241309520-fig1.jpg

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