Scoping Review of Health Literacy Interventions for Pregnant Women in Developing Countries

Abstract

Objective: To identify and describe health literacy interventions for pregnant women in developing countries, including characteristics, implementation strategies, and cultural adaptations.

Data sources: MEDLINE, Embase, Cochrane Library, CINAHL, Education Resources Information Center, reference lists, and Google Scholar.

Study selection: We considered reports of studies published from the inception of each database through December 24, 2024. We included studies in which researchers evaluated interventions designed to improve health literacy among pregnant women who received antenatal care in clinical or community settings. We included studies regardless of language. We excluded conference abstracts, essays, dissertations, review articles, and studies that did not meet inclusion criteria after full-text review.

Data extraction: We extracted information on author(s), year of publication, country, study design, setting, type of intervention, delivery strategies, factors influencing health literacy, and reported outcomes.

Data synthesis: We grouped and described studies according to the reported interventions. We included 23 studies conducted across Africa (n = 18), Asia (n = 4), and the Caribbean (n = 1). Identified interventions included group-based education (n = 8), one-on-one education (n = 11), mobile health interventions (n = 5), peer educator-based programs (n = 1), and community-based approaches (n = 3). Most interventions were delivered within antenatal care clinics, and some were delivered in community settings. Participatory strategies, such as storytelling, role-playing, and culturally tailored communication, were commonly used.

Conclusion: Health literacy interventions strengthen communication, knowledge, and health-care-seeking behaviors; however, challenges related to access to health care services, sustainability, and cultural adaptation underscore the need for intervention designs that meet local health care contexts in developing countries.

Keywords: antenatal care; developing countries; health literacy; health promotion; pregnant women.