背景:在资源不足的情况下,对现有卫生服务的不依从是卫生保健服务效率低下的主要原因.MHealth已被预测为在怀孕期间支持妇女的可能解决方案,出生和产褥期,增加对基本孕产妇服务的吸收。
目的:本系统评价和荟萃分析研究旨在确定短信服务(SMS)对中低收入国家(LMICs)重点产前检查(FANC)访视和熟练生育专业人员出勤的有效性。
方法:我们从电子数据库中搜索了大量文献-Cochrane综述,CINAHL,PsycINFO,PubMed和GoogleScholar收集有关SMS在FANC访问和熟练接生方面的作用的全面证据。我们仅从随机临床试验(RCT)中提取数据。在ReviewManager(RevMan)计算机软件中使用随机效应模型和逆方差方法进行Meta分析。纳入研究的质量由Gradepro确定,使用Cochrane协作偏倚风险工具评估偏倚风险。
结果:在筛选的1224篇非重复文章中,只有7项代表8324名参与者的RCT研究符合入选标准,并纳入本综述.在聚合上,实验组的FANC访视次数增加了174%(OR=2.74(95%CI:1.41,5.32),熟练助产率增加了82%(OR=1.82(95%CI;1.33,2.49)),这在统计学上有显著关联.I2检验结果表明高异质性I2=78%(P<.001)。纳入研究的总体质量中等,并且有低的偏见风险。
结论:SMS对LMICs中FANC就诊和熟练接生具有积极影响。针对孕妇的短信服务是无价的,负担得起的干预措施,以改善孕产妇寻求医疗保健的行为。
BACKGROUND: In low resource circumstances, non-adherence for available health services is a major cause of inefficiency in health care delivery. MHealth has been projected as a possible solution to support women during pregnancy, birth and puerperium period, to increase the uptake of essential maternal services.
OBJECTIVE: This systematic review and meta-analysis study was aimed to determine the effectiveness of short message services (SMS)on Focused Antenatal Care (
FANC) visits and the attendance of skilled birth professionals in Low and Middle Income Countries (LMICs).
METHODS: We searched a broad body of literature from electronic databases-Cochrane review, CINAHL, PsycINFO, PubMed and Google Scholar to collect comprehensive evidence on the role of SMS on
FANC visits and skilled birth attendance. We extracted data from randomized clinical trials (RCTs) only. Meta-analyses were conducted using random-effects models with inverse variance method in Review Manager (RevMan) computer software. Qualities of the included studies were determined by GRADEpro, and risk of bias was assessed using Cochrane Collaboration risk of bias tool.
RESULTS: Of the 1224 non-duplicated articles screened, only 7 RCT studies representing 8324 participants met eligibility criteria and included in this synthesis. On aggregate, there were statistically significant associations in experimental group in that pregnant mothers who received text messaging had a 174% increase in
FANC visits (OR = 2.74 (95% CI: 1.41, 5.32) and 82% in skilled birth attendance (OR = 1.82 (95% CI; 1.33, 2.49). The I2 test result indicated high heterogeneity I2 = 78% (P < .001). The overall qualities of included studies were moderate, and had low risk of bias.
CONCLUSIONS: SMS has positive effects for the uptake of
FANC visits and skilled birth attendance in LMICs. A short messaging service targeting pregnant woman is an invaluable, affordable intervention to improve maternal healthcare seeking behaviors.