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Abstract
Objectives Pregnant women in low- and middle-income countries (LMICs), including Mali, often face challenges such as limited access to comprehensive health information and services. Mobile health (mHealth) interventions, particularly SMS-based interventions, have shown promise in addressing maternal health challenges. This review aims to provide an overview of existing SMS-based antenatal care (ANC) applications and assess their effectiveness in improving maternal and child health outcomes.
Design A systematic literature review was conducted based on updated PRISMA 2020 guidelines.
Data sources PubMed, Scopus, Web of Science, Cochrane Library, Association for Information Systems eLibrary, Direct Science and Google Scholar were searched through 25 March 2024.
Eligibility criteria Studies that focused on SMS-based interventions designed to improve ANC information and attendance, published in English or French, conducted in LMICs and published between 2014 and 2024 were included. Exclusion criteria eliminated studies that did not report primary outcomes or did not directly involve SMS-based interventions for ANC.
Data extraction and synthesis Relevant data were systematically extracted, including study characteristics, intervention details, and outcome measures. The risk of bias was assessed using the Cochrane Risk of Bias tool for randomised trials (RoB 2), the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) and the Checklist for Reporting the Development and Evaluation of Complex Interventions in Healthcare (CReDECI), depending on the study design. A subgroup analysis was performed to explore variations in outcomes by region and study design.
Results The review identified a range of SMS-based interventions (n=12) that differed in target audience, message frequency (weekly, pregnancy stage-oriented) and content (reminders (91.7% of cases, 11/12), educational (75%) and danger signs (16.7%)). Regional analysis highlighted significant research activity in East Africa but with mixed significance levels. The study design analysis revealed that randomised controlled trials yielded the most significant results, with five of eight studies showing full significance, whereas quasi-experimental studies demonstrated consistent but less frequent effectiveness. Implementation tools varied from SMS gateways to custom applications and third-party platforms, with some interventions combining these approaches. SMS interventions positively impacted ANC attendance, maternal health knowledge and behaviours, with effectiveness varying based on the intervention type, content, frequency and implementation approach.
Conclusion SMS-based interventions have the potential to enhance ANC in LMICs by providing tailored health information and promoting healthy behaviours. Further research should focus on refining or replicating these interventions and exploring their long-term effects on maternal and child health outcomes, particularly in underrepresented regions.
- Health informatics
- Information technology
- Pregnant Women
- PUBLIC HEALTH
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. Extracted data, both raw and coded, are available upon reasonable request from the corresponding author.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
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STRENGTHS AND LIMITATIONS OF THIS STUDY
This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, ensuring a thorough and standardised approach to conducting the systematic review, thereby enhancing the transparency and reproducibility of the research process.
The risk of bias in the included studies was meticulously assessed using three robust tools: RoB 2, ROBINS-I and the CReDECI.
Data extraction and synthesis followed the predefined criteria to enhance the consistency and reliability.
A notable limitation is that only one reviewer assessed the included papers.
Quantitative statistical analysis typically performed in meta-analyses, such as pooled effect size calculation, was not undertaken, as the study was limited to a systematic review to inform our research focus.
Introduction
The lack of comprehensive health information and services for pregnant women is a significant challenge in improving maternal and child health in Mali and similar settings. Literature reports that knowledge of the place of consultation, treatment costs, pregnancy complications and the place of antenatal care (ANC) treatment influence maternal mortality.1 Additionally, regarding services, births attended by skilled health personnel correlate with maternal mortality in sub-Saharan Africa.2 Poor antenatal and maternal health awareness among pregnant women contributes to inadequate health behaviours and care-seeking, causing avoidable morbidity and mortality.
ANC is a critical component of maternal healthcare that aims to monitor and enhance the health outcomes of pregnant women and their unborn children. Regular ANC visits enable healthcare providers to detect and manage potential health problems, educate women about pregnancy and childbirth and advocate for healthy behaviours that benefit both the mother and the child.3–5 Despite the global recognition of ANC’s importance, significant challenges persist in ensuring comprehensive care for all pregnant women, particularly in low- and middle-income countries (LMICs). Studies have shown that maternal education, household income and cultural beliefs significantly affect the utilisation of ANC services, with disparities in access and use across different socioeconomic and demographic groups.5 6 Addressing these challenges requires targeted interventions to improve the access, awareness and affordability of ANC services for pregnant women in these regions.
The rapid growth of mobile technology has led to innovative ways of increasing healthcare access and engaging patients. SMS-based systems have become vital for closing information gaps and boosting engagement with ANC services. These applications offer a platform for delivering timely, relevant information directly to the mobile phones of pregnant women, thus increasing awareness of the importance of ANC, reminding women of their upcoming appointments and providing crucial health-related guidance.7–12 Studies have demonstrated the potential of mobile health (mHealth) interventions to monitor prenatal care among pregnant women in LMICs13 and have evaluated the effectiveness of SMS on focused ANC visits and skilled birth attendance in such settings.7
For instance, a meta-analysis found that mHealth interventions improved the uptake of four or more ANC visits among pregnant women in LMICs, with both one-way and two-way communication methods showing positive effects.14 SMS support during pregnancy was also associated with a decreased risk of perinatal death compared with routine prenatal care in one study.15 Interestingly, while SMS interventions generally improved ANC utilisation, their impact varied across contexts. In settings where facility delivery rates were already high, SMS interventions showed unclear effects. However, in areas with lower facility delivery rates, these interventions significantly increase facility-based deliveries.14
Despite rapid advancements in mobile health technologies, basic SMS remains a cornerstone in regions where limited internet access and low smartphone penetration hinder the adoption of complex systems. This review addresses the utility and effectiveness of SMS-based interventions in settings in which basic utilities such as electricity or the internet may be unreliable. By exploring the impact of SMS-based applications on metrics such as ANC visit attendance and skilled delivery attendance, we aim to clarify the potential of digital interventions to complement traditional ANC services and contribute to reducing maternal and neonatal morbidity and mortality, supporting public health goals16 and contributing to the broader global health narrative of health, sustainability and transformation.17
The remainder of this paper is organised as follows. The second section details the methodology by describing the research question, data sources, search strategy, selection criteria and data extraction process. It also presents the analysis tools, data characteristics and risk-of-bias assessment. The third section presents the results, which are discussed in section four along with limitations. Section five concludes the paper.
Methodology
A systematic approach was employed to identify and evaluate significant findings concerning the use of SMS-based interventions to improve ANC in developing countries, as documented in peer-reviewed online French and English journals over the past decade. To ensure a thorough and effective review process, we followed the updated guidelines outlined in the 2020 edition of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).18 The PRISMA 2020 Abstracts and Checklist items can be accessed from the online supplemental appendix. The review process, including screening, quality assessment and data extraction, was conducted by a single reviewer due to resource constraints and the need for language proficiency. To minimise potential bias, predefined inclusion and exclusion criteria were strictly followed, and standardised tools, such as RoB 2, ROBINS-I and ROBVIS, were applied to ensure methodological rigor.
Supplemental material
Research questions
The objectives of this study were to address the following research questions:
RQ1: What are the characteristics and availability of SMS-based applications developed between 2014 and 2024 to enhance ANC information and attendance among pregnant women in LMICs?
RQ2: How effective are these SMS-based applications in improving ANC information and attendance among pregnant women in LMICs compared with the usual care?
Data sources
The search included the following electronic databases or search engines: PubMed (last searched 19 March 2024), Scopus (last searched 21 March 2024), Web of Science (last searched 22 March 2024), Cochrane Library (last searched 20 March 2024), Association for Information Systems eLibrary (AISeL) (last searched 20 March 2024), Direct Science (last searched 21 March 2024) and Google Scholar (last searched 25 March 2024). These searches were conducted to ensure the inclusion of the most up-to-date and relevant literature.
Search strategy
The formulated research questions guided the construction of the search strings, leading to their combination through logical connectors. The resulting string was [(“SMS-based applications” OR “text messaging” OR “mobile health” OR “mHealth”) AND (“antenatal care” OR “prenatal care” OR “pregnancy care” OR “ANC”) AND (“developing countries” OR “low-income countries” OR “resource-limited settings”)]. This process was adapted according to the requirements of each electronic database. Science Direct, for example, did not accept more than eight logical connectors in a single search. The author translated the search string into French by combining words and expressions used in the English search. The resulting string was (“applications basées sur SMS” OU “messagerie texte” OU “santé mobile” OU “mSanté”) ET (“soins prénatals” OU “soins anténataux” OU “soins pendant la grossesse” OU “CPN”) ET (“pays en développement” OU “pays à faible revenu” OU “contextes à ressources limitées”). The process used for searching and selecting different publications is summarised in a Diagram Flow and presented in figure 1. The flow diagram of the search was created using the R-developed online tool by Haddaway et al.19 Online supplemental eTable 1 summarises the full search strategy, and online supplemental eTable 2 details the results per database.
Supplemental material
Flow diagram of the search.
Selection criteria
Initially, 776 publications were found, as detailed in online supplemental eTable 2. Additional inclusion and exclusion criteria were applied to shift the initial findings to pinpoint studies pertinent to our goals. Consequently, these publications underwent a rigorous screening process based on the inclusion and exclusion criteria. These criteria were defined to ensure the relevance and quality of the analysed data. The study design criteria included randomised controlled trials (RCTs), quasi-experimental, observational and qualitative studies that provided data on the implementation, usage and outcomes of SMS-based ANC interventions. Editorials, reviews, opinion pieces and studies lacking primary data or clear outcomes related to ANC and SMS-based interventions were excluded.
The population criteria focused on studies involving pregnant women in LMICs encompassing women of all ages, ethnicities and stages of pregnancy. For the intervention criteria, the studies needed to focus on SMS-based systems designed to improve ANC information and attendance. These included interventions promoting health education, appointment reminders, health monitoring and support through text messaging. Studies that did not specifically use SMS-based communication as the primary method for delivering ANC information or support were excluded. Criteria such as comparators, outcomes, publication dates and languages were also used. Online supplemental eTable 3 provides a detailed description of the inclusion and exclusion criteria, along with the rationale for each criterion. In the subsequent phase, the process involved verifying the presence of duplicate papers given that multiple databases were used for the search. This resulted in identifying and removing 11 duplicate documents from the dataset. Full texts of papers were then retrieved and checked. Following this meticulous selection phase, a final count of 12 papers was deemed appropriate and suitable for review (figure 1).
Data extraction
After completing the selection process, we extracted information from the selected papers. The study identification items included author names, paper title, journal, publication year, study design type and the country where the study was conducted. Details regarding the study participants were also extracted, including an accurate description of the study population, sample size and primary inclusion and exclusion criteria. Information on the intervention details extracted includes a description and purpose of the SMS-based application as presented in the paper, the content of messages, frequency of sending, resources and tools for implementation and intervention duration. Additionally, control or comparator interventions were retrieved as reported, if applicable. The reported outcomes (primary and secondary) were then extracted. Key findings related to the indicated outcomes, statistical significance where applicable and any reported limitations were also extracted. The complete data extraction form is provided in online supplemental eTable 4.
Tools and analysis
The data set was managed using the open-source desktop-based application Mendeley version 1.19.8. The extracted items were stored and used to generate descriptive statistics using JabRef (version 5.13), Microsoft 365 Excel (version 2403) and IBM SPSS Statistics 20.
Patient and public involvement
None.
Data characteristics
A bibliometric overview of the selected papers is described in table 1. Each paper was assigned a numerical identifier and categorised according to the year of publication, from oldest to most recent and by source.
Bibliometric overview
Risk-of-bias assessment
In this study, the dataset comprised 12 scholarly articles. Each article was evaluated for potential bias, with assessment criteria varying according to the study design. Three distinct tools were used to conduct this assessment: version 2 of the Cochrane Risk-of-Bias tool for randomised trials (RoB 2)20 was applied to eight studies, the Risk Of Bias In Non-randomised Studies—of Interventions (ROBINS-I) tool21 to three studies and the Checklist for Reporting the Development and Evaluation of Complex Interventions in Healthcare22 were conveniently used for one study. Visual representations of the assessments, including traffic light plots (see online supplemental eFigure 1,2) and summary plots (see online online supplemental eFigures 3,4), were created for the two groups (RoB two and ROBINS-I). Refer to online supplemental eFigures 5 to the assess the study using the checklist. These plots were generated using the Risk Of Bias VISualisation tool.23 The overall risk assessment for the papers was categorised as ‘some concerns’. Consequently, we did not exclude any of the documents included due to the absence of many significant high/critical issues with individual papers.
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Results
SMS app inventory (RQ1)
Overview of apps
The dataset consists of 12 applications. These ranged from basic, one-way SMS-sending apps to more complex, bidirectional communication platforms that connect pregnant women with healthcare providers throughout and sometimes beyond the pregnancy period. Table 2 provides an overview of the identified apps and offers details on each app’s target population, key features and study design employed to evaluate its effectiveness. App names are given where the authors gave specific names to their developed apps.
Overview of apps
Detailed app descriptions
This subsection comprehensively describes each application based on extracted data. Essential intervention details, such as message content, sending frequencies and the development tools used (see table 3), are provided.
Detailed app descriptions
Effectiveness Evidence (RQ2)
Overview of studies
Among the 12 studies, six primary outcomes were identified and further classified into effectiveness and safety domains, as well as primary and secondary categories. Primary effectiveness outcomes included improved attendance (n=9) and skilled delivery attendance (n=4). The primary safety outcomes included a reduction in neonatal mortality (n=1) and reduced complications (n=1). Secondary effectiveness outcomes included increased knowledge (n=3) and patient satisfaction (n=1). Online supplemental eTable 5 provides a detailed breakdown of these outcomes categorised by study design.
Regarding the message content sent to participants (including women and, in one case, their male partners24), the key themes revolved around appointment reminders (observed in 11 studies, representing 91.7% of cases), educational content (75% of cases), emergency or danger alerts (16.7% of cases) and combinations of these themes (66.7% of cases).Online supplemental eFigure 6 illustrates the frequency of SMS content types across the different apps. For the detailed content types per study, please refer to table 3.
Supplemental material
The SMS-sending frequency was consistent across the studies. In five studies, messages were sent weekly, while in other cases, the frequency was adjusted according to the pregnancy stage or specific contextual timing. For instance, in the setup described by Masoi and Kibusi,9 the frequency varied by pregnancy stage: one message per week during the first trimester, two per week in the second trimester and three per week in the third trimester. These variations were noted in eight studies, including some that used weekly SMS during certain phases or daily SMS from delivery to 2 weeks postpartum.10 A common trend in apps using varied frequencies was a systematic increase in message intervals as the delivery date approached. Table 2 provides detailed information on each application. The intervention durations varied, with some lasting less than 3 months (16.7%), others ranging from 3 to 6 months (16.7%), some spanning 6 to 12 months (41.7%) and three studies exceeding 12 months (25%).
The breakdown of development tools or approaches for app implementation is as follows. An SMS gateway (26.67% usage rate among evaluated apps) facilitates the efficient delivery and receipt of text messages, making it suitable for large-scale messaging campaigns due to its simplicity.25 Custom apps (36.67%) provide personalised features like interactive messaging and data analytics, demanding substantial development resources while offering significant customisation. Third-party platforms (16.67%) are pre-built solutions with scheduling and often analytics features but may lack the flexibility of custom apps. A combined approach (20% usage rate) combines the strengths of multiple tools, such as using a custom app for analytics along with an SMS gateway or a third-party platform for messaging, allowing for simplicity, customisation and scalability tailored to various SMS interventions.26 The specific names and/or platforms used by each app (when provided in the article corpus) are listed in table 2.
Study findings
Unsurprisingly, all studies highlighted the significant impact of SMS-based interventions on maternal healthcare. Lund et al12 discovered a substantial rise in ANC attendance, with women adhering to the WHO recommendations for four or more visits. The same has been observed in other studies.8 24 27 28 Moreover, they12 observed an increase in skilled delivery attendance among urban women, with an OR of 5.73 (95% CI: 1.51 to 21.81). Notably, it significantly reduced perinatal mortality, with an OR of 0.50 (95% CI: 0.27 to 0.93). Ronen et al,10 in the pilot phase29 of their ongoing randomised controlled study (Mobile WACh NEO RCT), identified that among women residing in areas with elevated rates of stillbirth, perinatal and infant mortality, increasing maternal age was the sole predictor of stillbirth. It is essential to highlight that although we included their main study in our dataset, the results have not yet been compiled and published as of the writing of this paper. The trial concluded with participant enrolment (5020 participants) on 30 June 2022, and follow-up was scheduled to continue until February 2023.30 Consequently, we relied on the pilot-phase results.29 Table 4 shows the different studies along with the effect sizes and statistical significance of their primary outcomes, as reported in the content of the papers.
Effectiveness evidence
Subgroup analysis
Subgroup analysis explored the distribution and outcomes of the interventions across regions, study designs and intervention types, providing a better understanding of the factors influencing their effectiveness.
Regional distribution and significance
Regional distribution analysis revealed notable differences in the number of studies, outcomes and study-level significance across global regions. Five studies were conducted in East Africa (Ethiopia, Kenya, Tanzania and Uganda). Of these studies, four reported outcomes that were statistically significant,9 12 24 28 and one did not indicate significance (pilot).29 This highlights the region’s robust research activity. Three studies in West Africa (Ghana and Nigeria) emphasised the effectiveness of interventions in this region.8 31 Asia (Pakistan and Timor-Leste), the Middle East (Iraq), and South America (Brazil) are underrepresented with only one study per country.
Impact of study designs
RCTs dominated the dataset, with eight studies spanning East and West Africa and Asia. Of these, five demonstrated all outcomes as significant, while two reported partial significance (see online supplemental eTable 6). This reflects the robustness of the RCT design in yielding significant findings, although with some variations. Quasi-experimental studies, the second most common design, include three studies from Ghana, Tanzania and Timor–Leste. Two of these achieved full significance, while one fell under the ‘not applicable’ category. A sociotechnical approach using a prototype method is less common, as represented by a single study. It reports fully significant outcomes, indicating potential but limited generalisability due to their low frequency.
Effectiveness of intervention types
The intervention-type analysis revealed critical trends in the study’s effectiveness and applicability. Mixed interventions (educational and reminders) are the most prevalent, with six studies across diverse regions including Africa, Asia and the Middle East. Among these, five reported full significance, while one indicated partial significance. Educational messages, implemented in Brazil, Kenya and Tanzania, are associated with three studies, of which two demonstrated significant outcomes and one was categorised as ‘not applicable’. Reminders applied in Ethiopia, Nigeria and Uganda show similar proportions, with two studies achieving full significance and one partial significance (refer to online supplemental eFigure 7).
Supplemental material
Discussion
The findings underscore the potential of SMS-based interventions to enhance ANC attendance, maternal health knowledge and service utilisation in LMICs. Across the studies reviewed, SMS interventions demonstrated varying degrees of effectiveness (see table 4), reflecting diversity in implementation approaches, population contexts and healthcare systems.
Studies12 28 highlighted substantial improvements in ANC attendance and skilled delivery rates, with ORs and effect sizes indicating robust effects. These findings suggest that SMS reminders and educational messages can effectively address common barriers to maternal healthcare, such as a lack of awareness or forgetfulness. However, the mixed outcomes observed in some studies, such as32 who reported a limited impact on ANC visits despite significant improvements in skilled delivery and facility-based births, indicate the need for context-specific tailoring of message content and delivery frequency.
The review highlights the strong influence of SMS-based interventions on maternal health knowledge and birth preparedness. For instance, Masoi and Kibusi9 reported large effect sizes in knowledge about obstetric and newborn danger signs, while Batool et al33 emphasised knowledge gains despite the limited impact on follow-up visits. Effective interventions appear to combine timely reminders with actionable health education, reinforcing preparedness and engagement. Participant satisfaction was consistently high across studies such as Alhaidari et al27 and Oliveira-Ciabati et al,34 where users expressed positive feedback about the usability and relevance of SMS interventions. High engagement levels, including two-way communication and interactive features, were associated with better adherence to health recommendations. These results suggest that user-centred design and feedback mechanisms are critical to the success and sustainability of SMS interventions. However, interactive features in some cases might not be ideal in low-resource settings as it implies the use of advanced technologies (smartphones) that are not necessarily accessible to the targeted women.
Our subgroup analysis revealed regional, methodological and intervention-type variations in the effectiveness of the SMS-based ANC interventions. East Africa had the highest research activity, with most studies reporting statistically significant outcomes, whereas other regions, including West Africa, Asia, the Middle East and South America, were underrepresented. RCTs demonstrated the strongest evidence. Mixed interventions combining educational messages and reminders were the most effective, highlighting the importance of multifaceted approaches over stand-alone reminders or educational messages. These findings emphasise the need for further research in underrepresented regions and deeper exploration of intervention strategies to optimise SMS-based maternal health programmes.
Despite these positive findings, this review also revealed limitations in the effectiveness of SMS interventions. For instance, Kawakatsu et al35 reported variability in effectiveness across different health services, such as higher adherence to vaccination schedules but no significant improvement in ANC or family planning return rates. Others33 have identified logistical barriers and social norms as factors that limit follow-up visits. These mixed outcomes emphasise the need for comprehensive programme designs that account for broader systemic and sociocultural factors influencing maternal health behaviours.
Moreover, based on our risk assessment, most studies were categorised as having ‘some concerns’, with no studies excluded because of critical methodological flaws. While this suggests a moderate level of reliability, certain biases may still affect the interpretation of the results. For example, it12 exhibited high bias in two domains (D2: bias due to deviations from intended intervention and D4: bias in the measurement of outcomes), which may impact the validity of its reported reduction in perinatal mortality and maternal health improvements. Similarly, Muhoza et al24 had a high D2, suggesting potential concerns regarding deviations from the intended intervention (see online supplemental eFigure 1). In the case of8 9 serious bias due to confounding factors (D1, ROBINS-I) may influence the observed significant effect sizes in primary outcomes and maternal health benefits. Additionally, Thompson et al,32 who demonstrated improvements in skilled birth attendance and facility deliveries, had a serious concern with D5 (bias due to missing data), potentially affecting the reliability of their findings see online supplemental eFigure 2. The study,34 assessed with a checklist for reporting the development and evaluation of complex interventions in healthcare, was concerned with sustainability (D8), which may limit its long-term applicability (see online supplemental eFigure 5).
Despite these biases, the collective evidence supports the positive impact of SMS-based interventions on ANC attendance, maternal health outcomes and service utilisation. However, these findings should be interpreted with caution because of potential methodological limitations.
Limitations and future research
Our study acknowledges several limitations that may influence the generalisability and applicability of the findings. This systematic review was not pre-registered in a database, which may be considered a limitation. However, as no clinical data were involved, registration was not mandatory. We ensured methodological transparency by outlining our search strategy, inclusion criteria and quality assessment approach. The review process was conducted by a single reviewer, which, despite ensuring a consistent approach, could introduce bias and limit the breadth of interpretation typically enriched by multi-reviewer analyses. Resource constraints and the availability of language-proficient subject matter experts necessitate this approach. To mitigate potential bias, rigorous adherence to predefined inclusion and exclusion criteria was maintained throughout the process. Although not optimal, this approach ensured the feasibility of the study within the available resources. Moreover, given that this study is focused solely on a systematic review, as stated, we did not conduct quantitative statistical analyses typically required for meta-analysis, such as pooled effect size calculations or heterogeneity tests (eg, prediction Intervals, or I²).36 While these methods could have added quantitative depth, they were not necessary to achieve the primary objective of synthesising and qualitatively analysing the evidence to inform our research focus. This methodological void should be addressed in future studies. Although we identified a concentration of studies from East Africa (5 of 12), this likely reflects the higher volume of SMS-based ANC interventions conducted and published in this region. Despite our comprehensive search strategy, studies from other LMICs may have been underrepresented or uncaptured, highlighting the need for further research in diverse geographical contexts to improve generalisability.
Conclusion
This review shows that mobile health interventions hold significant promise for improving maternal health outcomes, particularly in LMICs (see online supplemental eFigure 8). The interventions demonstrated positive effects on ANC attendance, health knowledge and general maternal health behaviours, underscoring the value of digital health tools in resource-limited settings. However, the effectiveness of these interventions varied widely and was influenced by factors such as the content and frequency of messages and the implementation tools used. Continued efforts in this field can significantly reduce barriers to ANC and improve maternal and child health outcomes.
Supplemental material
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. Extracted data, both raw and coded, are available upon reasonable request from the corresponding author.
Ethics statements
Patient consent for publication
Ethics approval
This study does not involve human participants. Ethical approval was not required for this systematic review, since all data came from published articles.
Acknowledgments
I am grateful for the initial assistance provided by KWF, who generously facilitated access to the necessary databases, enabling us to initiate this review. I also thank MM for providing access to comprehensive databases and for ensuring the continuity and successful completion of this work.
Footnotes
X @mkantem
Contributors MK: project administration, conceptualisation, methodology, writing original draft preparation, data curation, formal analysis after paper selection. MM: conceptualisation, writing-reviewing, editing and supervision. All the authors approved the final manuscript. The corresponding author (MK), as guarantor, accepts full responsibility for the finished article, has access to alldata and controls the decision to publish. While preparing this work, the authors used Chat GPT 4 and 4o to improve readability and language. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the publication’s content.
Funding This work is part of a study funded by the National Institute for Health and Care Research (UK) through the Royal Society of Tropical Medicine and Hygiene (RSTMH) 2023 Early Career Grants Programme https://www.rstmh.org/news-blog/blogs/nihr-grant-awardees-2023
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Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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