mHealth interventions to reduce maternal and child mortality in Sub-Saharan Africa and Southern Asia: A systematic literature review

Bossman, Elvis; Johansen, Monika Alise; Zanaboni, Paolo

doi:10.3389/fgwh.2022.942146

Cited by 20 publications

(9 citation statements)

References 62 publications

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“…The review is focused on SSA, a region that is currently struggling with the low use rates of maternal health services and identifying ways to improve maternal health outcomes, including a reduction in morbidity and mortality, is a priority [45]. As mHealth use continues to be promoted as one of the innovative ways to improve maternal health use in SSA, we anticipate the results of this review to be important to program implementers, policy makers, and researchers [46,47]. For implementers and policy makers, the results will inform how to use mHealth interventions based on what has been shown to work in other contexts.…”

Section: Discussionmentioning

confidence: 99%

Adoption of mHealth Technologies by Community Health Workers to Improve the Use of Maternal Health Services in Sub-Saharan Africa: Protocol for a Mixed Method Systematic Review

Kachimanga¹,

Divala²,

Ket³

et al. 2023

JMIR Res Protoc

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Background Studies have shown that mobile health technologies (mHealth) enhance the use of maternal health services. However, there is limited evidence of the impact of mHealth use by community health workers (CHWs) on the use of maternal health services in sub-Saharan Africa. Objective This mixed method systematic review will explore the impact of mHealth use by CHWs on the use of the maternal health continuum of care (antenatal care, intrapartum care, and postnatal care [PNC]), as well as barriers and facilitators of mHealth use by CHWs when supporting maternal health services. Methods We will include studies that report the impact of mHealth by CHWs on the use of antenatal care, facility-based births, and PNC visits in sub-Saharan Africa. We will search 6 databases (MEDLINE, CINAHL, Web of Science, Embase, Scopus, and Africa Index Medicus), with additional articles identified from Google Scholar and manual screening of references of the included studies. The included studies will not be limited by language or year of publication. After study selection, 2 independent reviewers will perform title and abstract screening, followed by full-text screening to identify the final papers to be included. Data extraction and risk-of-bias assessment will be performed using Covidence software by 2 independent reviewers. We will use a Mixed Methods Appraisal Tool to perform risk-of-bias assessments on all included studies. Finally, we will perform a narrative synthesis of the outcomes, integrating information about the effect of mHealth on maternal health use and barriers and facilitators of mHealth use. This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. Results In September 2022, we conducted an initial search in the eligible databases. After removing duplicates, we identified 1111 studies that were eligible for the title and abstract screening. We will finalize the full-text assessment for eligibility, data extraction, assessment of methodological quality, and narrative synthesis by June 2023. Conclusions This systematic review will present new and up-to-date evidence on the use of mHealth by CHWs along the pregnancy, childbirth, and PNC continuum of care. We anticipate the results will inform program implementation and policy by highlighting the potential impacts of mHealth and presenting contextual factors that should be addressed to ensure the success of the programs. Trial Registration PROSPERO CRD42022346364; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346364 International Registered Report Identifier (IRRID) DERR1-10.2196/44066

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Section: Discussionmentioning

confidence: 99%

Adoption of mHealth Technologies by Community Health Workers to Improve the Use of Maternal Health Services in Sub-Saharan Africa: Protocol for a Mixed Method Systematic Review

Kachimanga¹,

Divala²,

Ket³

et al. 2023

JMIR Res Protoc

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“…In Africa, mobile phones are displacing radio and television as a means of social communication [ 118 ]. Mass media and educational interventions based on SMS and voice message reminders should be used to increase pregnant women’s prenatal visits [ 119 , 120 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal Mortality in Africa: Regional Trends (2000–2017)

Onambele

Ortega-Leon

Guillen-Aguinaga

et al. 2022

IJERPH

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Background: United Nations Sustainable Development Goals state that by 2030, the global maternal mortality rate (MMR) should be lower than 70 per 100,000 live births. MMR is still one of Africa’s leading causes of death among women. The leading causes of maternal mortality in Africa are hemorrhage and eclampsia. This research aims to study regional trends in maternal mortality (MM) in Africa. Methods: We extracted data for maternal mortality rates per 100,000 births from the United Nations Children’s Fund (UNICEF) databank from 2000 to 2017, 2017 being the last date available. Joinpoint regression was used to study the trends and estimate the annual percent change (APC). Results: Maternal mortality has decreased in Africa over the study period by an average APC of −3.0% (95% CI −2.9; −3,2%). All regions showed significant downward trends, with the greatest decreases in the South. Only the North African region is close to the United Nations’ sustainable development goals for Maternal mortality. The remaining Sub-Saharan African regions are still far from achieving the goals. Conclusions: Maternal mortality has decreased in Africa, especially in the South African region. The only region close to the United Nations’ target is the North African region. The remaining Sub-Saharan African regions are still far from achieving the goals. The West African region needs more extraordinary efforts to achieve the goals of the United Nations. Policies should ensure that all pregnant women have antenatal visits and give birth in a health facility staffed by specialized personnel.

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“…Success stories of mHealth have been documented in Asia. A systematic literature review conducted in Sub-Saharan Africa and southern Asia mentioned that simple mHealth educational interventions based on SMS and voice message reminders effectively supported behaviour changes in pregnant women and training of health workers, thus improving antenatal and postnatal care attendance, vaccination coverage, and skilled birth attendance [10]. Mobile platform-based interventions remain a promising avenue for education and information dissemination, particularly for health-related topics that carry a significant potential to improve individual and population health and well-being, such as maternal and reproductive health.…”

Section: Need For Nutrition Education Through a Personalised Approach...mentioning

confidence: 99%

Mobile Phone-Based Nutrition Education Targeting Pregnant and Nursing Mothers in Sri Lanka

Peiris¹,

Wijesinghe²,

Gunawardana³

et al. 2023

IJERPH

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Introduction: A woman’s nutrition during pregnancy and nursing affects the mother and the growing child. Similarly, the first two years of a child’s life are critical to their growth and development and are facilitated by optimum nutrition. Women’s nutrition-related knowledge, attitudes, and practices influence household food and nutrition security. Mobile health (mHealth) is a potentially effective health intervention in pandemic situations when physical gatherings are restricted. Objectives: To examine the effectiveness of a mobile phone-based nutrition education intervention targeting pregnant and nursing mothers in six Sri Lankan divisional secretariat areas. Method: This intervention was evaluated using a before and after within-subjects design. The intervention included 19 messages over four weeks sent via mobile phone, covering nutrition themes such as pregnancy care, infant and young child-feeding, diet, family care for mother and child, and cash management. The intervention was evaluated based on a quantitative survey using a structured interviewer-administered questionnaire and qualitative interviews using a semi-structured questionnaire. The study population was pregnant and nursing mothers. The objective of the qualitative interviews was to identify how respondents used messages and how satisfied they were with the project. The outcome measures were awareness/knowledge, attitudes, social norms, self-efficacy, behaviour intentions, and practices of pregnant and nursing mothers. Trained enumerators collected data using a mobile phone. Results: A total of 996 pregnant and nursing mothers participated in the pre-assessment survey, of which 720 completed the post-assessment. Most were nursing mothers (84.2% pre- and 78.9% post-assessment). Participants provided positive feedback on the intervention. Knowledge/awareness (t = −18.70, p < 0.01) and attitudes (t = −2.00, p < 0.05) increased when exposed to the intervention. Favourable improvements in the practices were also observed. Mothers’ practices related to breastfeeding and 24-h dietary diversity showed a statistically significant improvement. However, social norms and behaviour intentions did not significantly improve. The qualitative component also revealed favourable responses. Conclusion and Recommendations: The mobile intervention improved participants’ knowledge, awareness, attitude, and practices, but not social norms or behaviour intentions. This approach is recommended to be used on a larger scale in community settings. In addition, mobile technology could drive intervention in pandemic-related situations.

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mHealth interventions to reduce maternal and child mortality in Sub-Saharan Africa and Southern Asia: A systematic literature review

Cited by 20 publications

References 62 publications

Adoption of mHealth Technologies by Community Health Workers to Improve the Use of Maternal Health Services in Sub-Saharan Africa: Protocol for a Mixed Method Systematic Review

Adoption of mHealth Technologies by Community Health Workers to Improve the Use of Maternal Health Services in Sub-Saharan Africa: Protocol for a Mixed Method Systematic Review

Maternal Mortality in Africa: Regional Trends (2000–2017)

Mobile Phone-Based Nutrition Education Targeting Pregnant and Nursing Mothers in Sri Lanka

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