Effectiveness of mHealth interventions for maternal, newborn and child health in low- and middle-income countries: Systematic review and meta-analysis

摘要: Objective To assess the effectiveness of mHealth interventions for maternal, newborn and child health (MNCH) in low– middle– income countries (LMIC). Methods 16 online international databases were searched to identify studies evaluating impact on MNCH outcomes LMIC, between January 1990 May 2014. Comparable studies included a random–effects meta–analysis. Findings Of 8593 unique references screened after de–duplication, 15 research articles two conference abstracts met inclusion criteria, including 12 intervention three observational studies. Only two studies graded at low risk bias. Only one study demonstrated an improvement morbidity or mortality, specifically decreased risk perinatal death children mothers who received SMS support during pregnancy, compared with routine prenatal care. Meta–analysis infant feeding showed that prenatal interventions using SMS/cell phone (vs care) improved rates of breastfeeding (BF) within hour birth (odds ratio (OR) 2.01, 95% confidence interval (CI) 1.27–2.75, I2 = 80.9%) exclusive BF for three/four months (OR 1.88, CI 1.26–2.50, 52.8%) and six 2.57, 1.46–3.68, 0.0%). Included studies encompassed designed information delivery (n 6); reminders 3); communication 2); data collection test result turnaround peer group support (n 2) psychological 1). Conclusions Most MNCH LMIC are poor methodological quality few have evaluated impacts patient outcomes. Improvements intermediate outcomes nevertheless been reported many there is modest evidence that interventions delivered via SMS messaging can improve feeding. Ambiguous descriptions their mechanisms of present difficulties interpretation replication. Rigorous studies potential offer clearer underway