Publication:

Effectiveness of tele-nursing interventions on maternal and newborn health outcomes in low- and middle-income countries

Maternal and newborn health remains a major public health priority in low- and middle-income countries (LMICs), where limited access to quality healthcare contributes to high maternal and neonatal morbidity and mortality. Tele-nursing has emerged as an innovative digital health strategy to improve continuity of care by providing remote nursing assessment, education, counselling, monitoring, and follow-up throughout pregnancy and the postpartum period. This systematic review aimed to evaluate the effectiveness of tele-nursing interventions on maternal and newborn health outcomes in LMICs. A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, CINAHL, and the Cochrane Library for studies published between January 2010 and December 2025. The review followed the PRISMA 2020 guidelines, and study quality was assessed using the Cochrane Risk of Bias 2 tool, ROBINS-I, and the GRADE approach. Thirty-eight studies met the eligibility criteria and were included in the review. The findings demonstrated that tele-nursing interventions significantly improved antenatal and postnatal care attendance, maternal health knowledge, medication adherence, birth preparedness, exclusive breastfeeding, maternal psychological well-being, newborn care practices, immunization uptake, and patient satisfaction. Tele-nursing also enhanced continuity of care and facilitated early recognition and referral of maternal and neonatal complications. However, implementation challenges included limited digital infrastructure, poor internet connectivity, low digital literacy, and shortages of trained healthcare professionals. Overall, tele-nursing is an effective and feasible strategy for strengthening maternal and newborn healthcare in LMICs. Integrating tele-nursing into routine maternal health services may improve healthcare accessibility, quality of care, and progress toward achieving sustainable development goal 3.