Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review
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INTRODUCTION: Maternal and neonatal mortality remains high in many low- and middle-income countries (LMIC). Availability and use of mobile phones is increasing rapidly with 90% of persons in developing countries having a mobile-cellular subscription. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This systematic review assessed the effect of mHealth interventions that support pregnant women during the antenatal, birth and postnatal period in LMIC. METHODS: The review was registered with Prospero (CRD42014010292). Six databases were searched from June 2014-April 2015, accompanied by grey literature search using pre-defined search terms linked to pregnant women in LMIC and mHealth. Quality of articles was assessed with an adapted Cochrane Risk of Bias Tool. Because of heterogeneity in outcomes, settings and study designs a narrative synthesis of quantitative results of intervention studies on maternal outcomes, neonatal outcomes, service utilization, and healthy pregnancy education was conducted. Qualitative and quantitative results were synthesized with a strengths, weaknesses, opportunities, and threats analysis. RESULTS: In total, 3777 articles were found, of which 27 studies were included: twelve intervention studies and fifteen descriptive studies. mHealth interventions targeted at pregnant women increased maternal and neonatal service utilization shown through increased antenatal care attendance, facility-service utilization, skilled attendance at birth, and vaccination rates. Few articles assessed the effect on maternal or neonatal health outcomes, with inconsistent results. CONCLUSION: mHealth interventions may be effective solutions to improve maternal and neonatal service utilization. Further studies assessing mHealth's impact on maternal and neonatal outcomes are recommended. The emerging trend of strong experimental research designs with randomized controlled trials, combined with feasibility research, government involvement and integration of mHealth interventions into the healthcare system is encouraging and can pave the way to improved decision making on best practice implementation of mHealth interventions.
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Local contextualization is an important factor in the acceptance and successful adoption of mHealth projects.
“It also allowed for the development of an app that was locally contextualized, an important factor in the acceptance and successful adoption of mHealth projects [32,33].”
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- Authors
- Sondaal, S. F. V., Browne, J. L., Amoakoh-Coleman, M., Borgstein, A., Miltenburg, A. S., Verwijs, M., & Klipstein-Grobusch, K.
- Affiliations
- University Medical Center Utrecht (NL)
- University of Oslo (NO)
- Corresponding author
- Sondaal, Stephanie Felicie Victoria
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-05-04
- Volume
- 11
- Issue
- 5
- Pages
- e0154664
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4856298
- OpenAlex
- W2345359603
- Cited by
- 441
- References
- 59
- Citations by year
- 2026: 34 · 2025: 33 · 2024: 35 · 2023: 43 · 2022: 49 · 2021: 53 · 2020: 70 · 2019: 56 · 2018: 36 · 2017: 18 · 2016: 14
- FWCI
- 7.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IHI Repository (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Figshare (submittedVersion, cc-by)
- Funders
- Fogarty International Center (D43TW009140)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- mobile health, mobile health intervention, maternal health, newborn health, pregnant women, prenatal care, skilled birth attendance, postpartum care, health care utilization, vaccination coverage, low- and middle-income countries, maternal and neonatal outcomes, prenatal education
- MeSH terms
- Developing Countries, Female, Humans, Infant, Infant Mortality, Infant, Newborn, Male, Maternal Mortality, Pregnancy, Prenatal Care, Outcome Assessment, Health Care, Telemedicine, Perinatal Care, Cell Phone
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