A Scoping Review of Smartphone-Based Interventions for Improving Nutrition Literacy and Preventing Anemia During Pregnancy

Yuniasih Purwaningrum Purwaningrum; Syahrul Bariah Abdul Hamid; Khairil Anuar Bin Md. Isa

doi:10.47405/mjssh.v11i10.4228

Yuniasih Purwaningrum Purwaningrum Department of Basic Sciences, Faculty of Health Sciences, UiTM Selangor, Puncak Alam Campus, Malaysia
Syahrul Bariah Abdul Hamid Center for Dietetics Studies, Faculty of Health Sciences, UiTM Selangor, Puncak Alam Campus, Malaysia
Khairil Anuar Bin Md. Isa Department of Basic Sciences, Faculty of Health Sciences, UiTM Selangor, Puncak Alam Campus, Malaysi

DOI: https://doi.org/10.47405/mjssh.v11i10.4228

Keywords: Pregnancy Anemia, Health Literacy, Digital Interventions, mHealth, Iron Supplementation

Abstract

Anemia in pregnancy remains a major public health challenge in developing countries due to its harmful effects on mothers and fetuses. Smartphone technology offers new opportunities to deliver nutrition education and reduce this burden. This scoping review mapped and appraised evidence on smartphone-based interventions to improve nutrition literacy and prevent anemia among pregnant women. This review adapted the Joanna Briggs Institute (JBI) framework for scoping reviews. Literature searches were undertaken across major databases, including PubMed, Scopus, Web of Science, CINAHL, ProQuest, and relevant regional databases, focusing on publications from January 2015 through 2024. Eligible studies comprised experimental and observational research evaluating smartphone-based nutrition or anemia-related interventions among pregnant populations. Extracted data covered study design, intervention characteristics, outcomes, and contextual factors, which were subsequently analyzed thematically to synthesize findings and identify determinants of intervention success. Of 5,120 records identified, 11 studies met inclusion criteria. Interventions mainly used mobile apps, SMS reminders, and multimedia educational modules, with varying duration and intensity. Most studies reported positive outcomes: better adherence to iron supplementation, higher hemoglobin levels, and improved knowledge and self-care behaviors. However, effect sizes varied according to user engagement, digital literacy, content personalization, and integration with existing health services. Smartphone-based interventions show considerable promise for closing maternal nutrition-literacy gaps and preventing anemia, especially in resource-limited settings. Nevertheless, their effectiveness depends on cultural appropriateness, technological accessibility, and alignment with health systems. Future efforts should prioritize user-centered design, context-specific adaptation, and strategies that ensure long-term sustainability and equitable access.

Downloads

Download data is not yet available.

References

Aarons, G. A., Sklar, M., Mustanski, B., Benbow, N., & Brown, C. H. (2017). “Scaling-out” evidence-based interventions to new populations or new health care delivery systems. Implementation Science, 12(1), 1–13. https://doi.org/10.1186/s13012-017-0640-6

Ahmad, A., Wagustina, S., Dwiriani, C. M., Estuti, W., Salfiyadi, T., Arnisam, A., & Fitrianingsih, E. (2022). The Efficacy of Nutrition Education on Anemia and Upper Arm Circumference among Pregnant Women in Aceh Besar District of Indonesia during the Covid-19 Pandemic. Jurnal Gizi Dan Pangan, 17(1), 27–36. https://doi.org/10.25182/jgp.2022.17.1.27-36

Arifah, I., Pambarep, T. S. A., Khoiriyah, L., Kusumaningrum, T. A. I., Werdani, K. E., & Ngadiyono, P. (2023). Effectiveness of daily educational message on pregnancy anemia prevention behavior and knowledge: A pilot randomized controlled trial. Journal of Education and Health Promotion, 12, Article 296. https://doi.org/10.4103/jehp.jehp_108_23

Dewidar, O., John, J., Baqar, A., Madani, M. T., Saad, A., Riddle, A., … Welch, V. (2023). Effectiveness of nutrition counseling for pregnant women in low- and middle-income countries to improve maternal and infant behavioral, nutritional, and health outcomes: A systematic review. Campbell Systematic Reviews, 19(4). https://doi.org/10.1002/cl2.1361

Dieteren, C., Sarkar, S., Saharan, S., & Bonfrer, I. (2022). Effects of a smartphone application on maternal health knowledge and dietary diversity among pregnant women in india: A randomized single center pilot study. Journal of Global Health Reports, 6(Cc). https://doi.org/10.29392/001c.39604

Engidaw, M. T., Eyayu, T., & Tiruneh, T. (2022). The effect of maternal anaemia on low birth weight among newborns in Northwest Ethiopia. Scientific Reports, 12(1), 1–8. https://doi.org/10.1038/s41598-022-19726-z

Fatthy, A., & Ezzat, N. (2020). A Smartphone-Based Health Behavioral Intervention for Pregnant Women With Iron Deficiency Anemia. Egyptian Journal of Health Care, 11(2), 1163–1176. https://doi.org/10.21608/ejhc.2020.272613

Haruna, U., Dandeebo, G., & Galaa, S. Z. (2019). Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study. Advances in Public Health, 11. https://doi.org/10.1155/2019/9181758

Kare, A. P., & Gujo, A. B. (2021). Anemia among Pregnant Women Attending Ante Natal Care Clinic in Adare General Hospital, Southern Ethiopia: Prevalence and Associated Factors. Health Services Insights, 14, 1–9. https://doi.org/https://doi.org/10.1177/11786329211036303

Khasawneh, M. A. S. (2024). Educational Experience Using Smartphone Applications To.

Konje, E. T., Ngaila, B. V., Kihunrwa, A., Mugassa, S., Basinda, N., & Dewey, D. (2022). High Prevalence of Anemia and Poor Compliance with Preventive Strategies among Pregnant Women in Mwanza City ,.

Lizarte Simón, E. J., Khaled Gijón, M., Galván Malagón, M. C., & Gijón Puerta, J. (2024). Challenge-obstacle stressors and cyberloafing among higher vocational education students: the moderating role of smartphone addiction and Maladaptive. Frontiers in Psychology, 15(April), 1–10. https://doi.org/10.3389/fpsyg.2024.1358634

Nadziroh, I., Anwar, M. C., & Sudirman, S. (2020). The Effect of Application Anemia Management Module On Improving Maternal Behaviors and Hemoglobin Level among Pregnant Women with Anemia. International Journal of Nursing and Health Services (IJNHS), 3(5), 576–587. https://doi.org/10.35654/ijnhs.v3i5.330

Pinsuwan, S., Chatchawet, W., & Chunuan, S. (2022). Effectiveness of Interactive Learning via Multimedia Technology with Family Support Program among Pregnant Women with Anemia: A Quasi-Experimental Study. Pacific Rim International Journal of Nursing Research, 26(4), 600–612.

Prihanti, G. S., Imawan, R., Iskandar, F. Y., Diastuti, L. P., Adawiyah, R., Safrillia, S., … Giedraitis, V. (2022). the Effect of Sms Reminders and Counseling on Pregnant Women’S Adherence To Consuming Iron Tablets. Jurnal Berkala Epidemiologi, 10(3), 246–255. https://doi.org/10.20473/jbe.v10i32022.246-255

Rahman, R. A., Idris, I. B., Isa, Z. M., & Rahman, R. A. (2022). The effectiveness of a theory-based intervention program for pregnant women with anemia: A randomized control trial. PLoS ONE, 17(12 December), 1–16. https://doi.org/10.1371/journal.pone.0278192

Riset Dinas Kesehatan. (2018). Laporan Riskesdas 2018 Nasional. In Lembaga Penerbit Balitbangkes.

Rukmaini, R., Lipoeto, N. I., Masrul, M., & Effendi, N. (2019). The Effect of Health Education and Mobile Control Application Program on Anemia among Pregnant Women. Journal of Pharmacy and Nutrition Sciences, 9(6), 287–295. https://doi.org/10.29169/1927-5951.2019.09.06.1

Santos, W. M. Dos, Secoli, S. R., & Püschel, V. A. de A. (2018). The Joanna Briggs Institute approach for systematic reviews. Revista Latino-Americana de Enfermagem, 26, e3074. https://doi.org/10.1590/1518-8345.2885.3074

Shetty, A., Bhalerao, A., Kawathalkar, A., & Vashi, C. (2023). Effect of Educational Handouts With Standard Therapy Versus Standard Therapy Alone on Compliance With Oral Iron Supplementation in Antenatal Women With Iron Deficiency Anemia: A Randomized Controlled Trial. Cureus, 15(5). https://doi.org/10.7759/cureus.39508

Small, Z., Thompson, S. E., Sharma, A., Majumdar, S., Thout, S. R., & Praveen, D. (2024). Mobile health (mHealth) interventions for health promotion during the perinatal period in India: a scoping review Zara. (November), 1–15. https://doi.org/10.3389/fgwh.2024.1427285

Susilawati, E., Suryanti, Y., Sari, L. A., Herinawati, & Murtiyarini, I. (2021). The Impact of an Android Application on Compliance With Iron Supplementations in Pregnant Women. Journal of Client-Centered Nursing Care, 7(3), 237–244. https://doi.org/10.32598/JCCNC.7.3.380.1

Tiwari, A. K. M., Mahdi, A. A., Mishra, S., Parveen, H., & Fatima, G. (2020). Effect of iron and folate supplementation on Pb levels in pregnant anemic women: a prospective study. Free Radical Research, 54(8–9), 662–669. https://doi.org/https://doi.org/10.1080/10715762.2020.1825704

Wakwoya, E. B., Belachew, T., & Girma, T. (2023). Effect of intensive nutrition education and counseling on hemoglobin level of pregnant women in East Shoa zone, Ethiopia: randomized controlled trial. BMC Pregnancy and Childbirth, 23(1), 1–11. https://doi.org/10.1186/s12884-023-05992-w

Wang, L. J., Casto, B., Reyes-Molyneux, N., Chance, W. W., & Wang, S. J. (2024). Smartphone-based augmented reality patient education in radiation oncology. Technical Innovations and Patient Support in Radiation Oncology, 29(December 2023), 100229. https://doi.org/10.1016/j.tipsro.2023.100229

Widyawati, W., Jans, S., Utomo, S., van Dillen, J., & Janssen, L. L. M. L. (2015). A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: Perceptions of Indonesian nurse-midwives. BMC Pregnancy and Childbirth, 15(1), 1–8. https://doi.org/10.1186/s12884-015-0478-3

Wirawan, F., & Nurrika, D. (2022). Maternal pre-pregnancy anemia and childhood anemia in Indonesia: a risk assessment using a population-based prospective longitudinal study. Epidemiology and Health, 44, 1–10. https://doi.org/10.4178/epih.e2022100

Wulandari, A., Octaviani, D. A., & Fajrin, R. (2023). Health Education Of Anemia In Pregnant Women Using Pocketbook Media On Increasing Knowledge, Attitudes, And Compliance With Fe Tablet Consumption. Journal of Applied Health Management and Technology, 5(3), 91–98.