{"title":"Effectiveness of Nursing Interventions in Reducing Maternal Mortality in Resource-Limited Settings: A Systematic Review and Meta-Analysis.","authors":"Jasneet Kaur, Sheela Upendra","doi":"10.17533/udea.iee.v43n3e13","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of nurse-led or nurse-integrated interventions in improving maternal health outcomes, particularly antenatal care (ANC) attendance, in resource-constrained settings.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases including PubMed, Scopus, CINAHL and Web of Science were searched for studies evaluating the impact of nursing interventions on maternal health outcomes. Risk of bias was assessed using the Cochrane RoB 2 tool and Newcastle-Ottawa Scale. A random-effects meta-analysis was performed for studies reporting ANC attendance (4 and more visits). (PROSPERO CRD420251067253).</p><p><strong>Results: </strong>Of the 1038 records identified, 11 studies met the inclusion criteria, and 3 were eligible for meta-analysis. The pooled Odds Ratio for ANC attendance was 1.48 (95% CI = 1.06-2.08), indicating a statistically significant improvement. For facility use at birth, results also showed positive effects (OR=1.49, 95% CI = 1.21-1.77). Mortality-related outcomes showed a midwife-delivered postpartum hemorrhage bundle reduced a composite outcome including severe hemorrhage and death (RR = 0.40, 95% CI = 0.32-0.50) Narrative synthesis of other outcomes such as skilled birth attendance and maternal mortality also suggested a positive impact of nurse-led interventions.</p><p><strong>Conclusion: </strong>Nurse-led and nurse-integrated maternal health interventions significantly improve ANC utilization in low-resource settings. Policymakers should consider scaling these models as part of broader maternal health strategies.</p>","PeriodicalId":53477,"journal":{"name":"Investigacion y Educacion en Enfermeria","volume":"43 3","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674658/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Investigacion y Educacion en Enfermeria","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17533/udea.iee.v43n3e13","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To assess the effectiveness of nurse-led or nurse-integrated interventions in improving maternal health outcomes, particularly antenatal care (ANC) attendance, in resource-constrained settings.
Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases including PubMed, Scopus, CINAHL and Web of Science were searched for studies evaluating the impact of nursing interventions on maternal health outcomes. Risk of bias was assessed using the Cochrane RoB 2 tool and Newcastle-Ottawa Scale. A random-effects meta-analysis was performed for studies reporting ANC attendance (4 and more visits). (PROSPERO CRD420251067253).
Results: Of the 1038 records identified, 11 studies met the inclusion criteria, and 3 were eligible for meta-analysis. The pooled Odds Ratio for ANC attendance was 1.48 (95% CI = 1.06-2.08), indicating a statistically significant improvement. For facility use at birth, results also showed positive effects (OR=1.49, 95% CI = 1.21-1.77). Mortality-related outcomes showed a midwife-delivered postpartum hemorrhage bundle reduced a composite outcome including severe hemorrhage and death (RR = 0.40, 95% CI = 0.32-0.50) Narrative synthesis of other outcomes such as skilled birth attendance and maternal mortality also suggested a positive impact of nurse-led interventions.
Conclusion: Nurse-led and nurse-integrated maternal health interventions significantly improve ANC utilization in low-resource settings. Policymakers should consider scaling these models as part of broader maternal health strategies.
目的：评估在资源有限的情况下，护士主导或护士综合干预措施在改善孕产妇健康结果，特别是产前护理（ANC）出勤方面的有效性。方法：根据PRISMA指南进行系统评价和荟萃分析。检索了PubMed、Scopus、CINAHL和Web of Science等数据库，以评估护理干预对孕产妇健康结果的影响。使用Cochrane RoB 2工具和Newcastle-Ottawa量表评估偏倚风险。随机效应荟萃分析对报告ANC就诊（4次及以上）的研究进行。(布劳斯佩洛CRD420251067253)。结果：在确定的1038条记录中，11项研究符合纳入标准，3项研究符合meta分析的条件。ANC出席率的合并优势比为1.48 (95% CI = 1.06-2.08)，表明统计学上有显著改善。对于出生时使用设施，结果也显示出积极的影响（OR=1.49, 95% CI = 1.21-1.77）。死亡率相关结果显示，助产士接生的产后出血束降低了包括严重出血和死亡在内的复合结果（RR = 0.40, 95% CI = 0.32-0.50）。其他结果（如熟练助产和孕产妇死亡率）的叙事综合也表明，护士主导的干预措施具有积极影响。结论：护士主导和护士综合的孕产妇保健干预措施显著提高了低资源环境下ANC的利用率。决策者应考虑扩大这些模式，将其作为更广泛的孕产妇保健战略的一部分。
期刊介绍：
The mission of the journal of Nursing and Education is to present scientific and technical information about health, illnesses and related topics. The journal serves as the conduit [medium] through which the experiences of our own nursing and social science departments can be shared within Columbia and internationally. It is written primarily for nurses, general health practitioners and other related disciplines but can also be used by students and researchers.
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