Tele-Nursing Interventions for Maternal and Newborn Health in Low- and Middle-Income Countries: A Systematic Review

Abstract

Maternal and newborn health remains a major global public health priority, particularly in low- and middle-income countries (LMICs), where healthcare access, workforce shortages, poverty, geographical barriers, and inadequate healthcare infrastructure continue to contribute to preventable maternal and neonatal morbidity and mortality. Digital health innovations have emerged as promising approaches to address these challenges. Among these innovations, tele nursing has gained increasing attention as a strategy for delivering healthcare services remotely through telecommunications technologies. Tele-nursing encompasses nurse-led interventions such as telephone consultations, mobile health messaging, telemonitoring, video consultations, remote patient education, and digital follow-up care. This systematic review aimed to evaluate the effectiveness, feasibility, and challenges of tele-nursing interventions for maternal and newborn health in LMICs. A systematic search of relevant literature published between 2015 and 2025 was conducted using electronic databases including PubMed, Scopus, Web of Science, CINAHL, and Google Scholar. Studies examining nurse-led digital interventions among pregnant women, postpartum mothers, and newborns were included. The findings revealed that tele-nursing interventions significantly improved antenatal care attendance, maternal health knowledge, birth preparedness, breastfeeding practices, newborn care behaviors, immunization adherence, and postnatal follow-up. Tele-nursing also facilitated early identification of complications and enhanced continuity of care. However, implementation challenges including digital illiteracy, inadequate infrastructure, internet connectivity limitations, privacy concerns, and financial barriers were frequently reported. The review concludes that tele-nursing represents a cost-effective and scalable strategy for improving maternal and newborn health outcomes in LMICs. Strengthening digital infrastructure, enhancing nursing competencies, and integrating tele-nursing into national healthcare systems are essential to maximize its potential.