Barriers and facilitators of messaging platforms as a means of maternal support and care in rural communities: A systematic review
Bibliographic record
Abstract
Improving maternal support in rural communities through messaging platforms can be a crucial strategy for enhancing antenatal visit rates and improving maternal health outcomes. Currently, there is a significant gap in maternal healthcare access in rural areas, where pregnant women often face barriers such as distance to healthcare facilities, lack of healthcare providers, and limited access to educational resources. This review explored the barriers and facilitators to providing maternal support through messaging platforms. A protocol for this systematic review was developed and registered in the PROSPERO international prospective register of systematic reviews database (Registration number: CRD42023492705). A comprehensive search was conducted on OVID MEDLINE, OVID EMBASE, EBSCO CINAHL, and SCOPUS, focusing on primary research articles published between January 1, 2003, and January 30, 2025. Eligibility criteria required studies to report on maternal support utilizing messaging platforms in rural populations globally. The search strategy yielded a total of 665 studies, of which 15 studies met the eligibility criteria. The quality of eligible studies was evaluated using the Mixed Methods Appraisal Tool, and data were extracted from the articles and analyzed using the Consolidated Framework for Implementation Research. Evidence from the studies indicated that messaging interventions positively impacted maternal health knowledge, access to perinatal services, and communication. Significant barriers were identified, including network connectivity issues in rural areas, affordability of airtime and phones, storage capacity of phones, resistance based on religious beliefs, reliance on traditional birth attendants, and literacy challenges. Facilitators in the messaging interventions included the educational nature of the messages, tailored advice related to pregnancy stages, timely support from community health workers, and improved access to transport for healthcare visits. Tailoring interventions to specific community needs and incorporating educational elements can enhance the engagement and success of messaging platforms targeting maternal health. The identified barriers and facilitators can inform the effective use of messaging platforms by ensuring they are accessible, affordable, and culturally appropriate to support maternal health in rural communities. Trial registration PROSPERO international prospective register of systematic reviews database (Registration number: CRD42023492705).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.066 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.007 |
| Bibliometrics | 0.009 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".