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Maternal Health Outcomes of Digital Health Interventions in Southeast Asian Low- and Middle-Income Countries: Scoping Review
ABSTRACT
Background:
Maternal mortality remains a major public health concern in Southeast Asian low- and middle-income countries, where disparities in maternal health persist. Digital health interventions have increasingly been used to support maternal health services; however, the maternal health outcomes reported in these interventions have not been systematically analyzed across the countries in this region.
Objective:
This scoping review aimed to map maternal health outcomes from digital health intervention studies conducted in Southeast Asian low- and middle-income countries and to describe the characteristics of the interventions and the contextual barriers and enablers that influence those outcomes.
Methods:
This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and Joanna Briggs Institute guidance. PubMed, CINAHL, and Scopus were searched for English-language studies published between January 2005 and May 2025, with supplemental screening of Google Scholar and reference lists. Maternal health outcomes were mapped using a proximal-intermediate-distal framework, with proximal outcomes categorized into knowledge and psychobehavioral outcomes, and intermediate and distal outcomes defined as service utilization and biomedical measures. Contextual factors, including barriers and enablers, influencing implementation and outcome interpretation, were also extracted and synthesized. Data were charted and summarized descriptively.
Results:
A total of 36 studies were included, with the majority (61%) conducted in Indonesia. Digital health interventions primarily used mobile applications or short message service-based messaging (78%) and focused on targeted client communication or personal health tracking. Most of the studies (94%) evaluated proximal outcomes, while fewer assessed intermediate or distal outcomes. The reported barriers included limited access to digital devices, low levels of digital literacy, and challenges with network connectivity, while factors that facilitated the success of the interventions included widespread access to mobile phones and the use of customized or personalized intervention strategies.
Conclusions:
Digital health interventions in Southeast Asian low- and middle-income countries have primarily focused on proximal maternal health outcomes. The limited evaluations of service utilization and biomedical outcomes underscore the need for future evaluations to examine outcomes beyond early, proximal measures.
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Copyright
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