Effectiveness of WhatsApp-based education on improving access to maternal health: A systematic review

Access to timely and reliable maternal health information is a critical determinant of maternal and neonatal outcomes. Mobile health interventions, particularly WhatsApp, are increasingly used to overcome geographic, financial, and sociocultural barriers. However, evidence on their effectiveness in antenatal care (ANC) remains scattered.

To synthesize evidence on the effectiveness of WhatsApp-based educational interventions in improving knowledge, behaviors, psychological well-being, clinical outcomes, and service uptake among pregnant women.

Six databases (PubMed, Medline, SCOPUS, Web of Science, Cochrane Library, and Google Scholar) and reference lists were searched up to March 2025.

Eligible studies were randomized controlled trials (RCTs) or quasi-experimental designs evaluating WhatsApp-based interventions in pregnant women, compared with routine ANC or other educational modalities.

Screening and data extraction were performed independently by two reviewers using Rayyan. Given heterogeneity in interventions and outcomes, findings were synthesized narratively.

Of 4374 records identified, 21 studies (12 RCTs, 9 quasi-experimental) were included. Most studies (76%) enrolled ≤50 participants per WhatsApp arm and were conducted in upper-middle and high-income countries. WhatsApp-based interventions improved maternal knowledge (e.g., anemia prevention, breastfeeding), health behaviors (self-care, smoking cessation, and dietary practices), psychological outcomes (reduced anxiety, depression, tokophobia and improved maternal-fetal attachment), clinical outcomes (hemoglobin, blood pressure and glycemic control), and ANC attendance and satisfaction. However, WhatsApp was less effective than motivational interviewing, phone calls, or face-to-face education in some domains.

Heterogeneity in interventions and outcome measures precluded meta-analysis. Most studies were small, for a short term, and concentrated in higher-income settings.

WhatsApp-based education is a feasible, low-cost adjunct to routine ANC that can improve knowledge, health behaviors, psychological well-being and satisfaction. Future research should prioritize large-scale, multicenter RCTs in low-resource settings, with standardized outcome measures and long-term follow-up, to establish effectiveness and scalability.