Maternal Decision-Making around Digital Birth Preparedness in Resource-Limited Settings: A Narrative Review

Wang Chunxiang; Ali Napiah Nasution; Liena

doi:10.61919/xnbxqz85

Authors

Wang Chunxiang Obstetrics Department, Universitas Prima Indonesia, Indonesia Author
Ali Napiah Nasution Obstetrics Department, Universitas Prima Indonesia, Indonesia Author
Liena Obstetrics Department, Universitas Prima Indonesia, Indonesia Author

DOI:

https://doi.org/10.61919/xnbxqz85

Keywords:

Digital Birth Preparedness; Maternal Decision-Making; mHealth; Birth Preparedness and Complication Readiness; Antenatal Care; Skilled Birth Attendance; Emergency Obstetric Referral; Resource-Limited Settings.

Abstract

Background: Digital birth preparedness is increasingly promoted to improve maternal knowledge, antenatal engagement, and complication readiness in resource-limited settings, yet its influence on maternal decision-making depends on autonomy, household negotiation, phone access, privacy, trust, and health-system responsiveness. Objective: This narrative review synthesized recent evidence on how digital birth-preparedness interventions influence maternal decision-making, care-seeking, equity, privacy, and implementation in low-resource contexts. Methods: Literature published between January 2016 and May 2026 was reviewed from PubMed/MEDLINE, Scopus, Google Scholar, and institutional sources including the World Health Organization, UNFPA, UNICEF, International Telecommunication Union, GSMA, and the World Bank. Evidence from systematic reviews, intervention studies, qualitative research, implementation evaluations, and policy reports was synthesized thematically. Results: Digital interventions, including SMS reminders, voice messages, helplines, mobile applications, community health worker tools, electronic registers, and digital referral systems, can improve maternal knowledge, appointment recall, antenatal contact, and selected service-use behaviours. However, evidence is stronger for intermediate outcomes than for emergency referral completion, maternal mortality reduction, or sustained decision agency. Their impact is moderated by women’s control over phones, literacy, language, household authority, transport, cost, perceived quality of care, privacy safeguards, and facility readiness. Conclusion: Digital birth preparedness should be understood as health-system-integrated decision support rather than a stand-alone messaging strategy. Programmes are most likely to improve maternal decision-making when they combine timely information with community health worker support, respectful maternity care, emergency referral capacity, equity-sensitive design, and privacy-protective governance.

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