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☐ ☆ ✇ BMJ Open

Multimorbidity before, during and after pregnancy among women in low-income and middle-income countries: protocol for a scoping review

Por: Ramokolo · V. · Roomaney · R. A. · Maqungo · M. · Nyirenda · M. · Puri · P. · Yakubu · K. · Gummidi · B. · Zembe-Mkabile · W. · Xu · X. · McCauley · M. — Septiembre 24th 2025 at 03:32
Introduction

The co-occurrence of multiple long-term conditions, that is, multimorbidity, is increasing globally and is associated with lower quality of life and increased risk of death. The risk and prevalence of multimorbidity are higher among women compared with men, but currently, evidence focusing on women’s multiple long-term conditions during the perinatal period is limited. Existing evidence needs to be examined to determine the extent to which maternal multimorbidity or women’s multiple health needs related to pregnancy have been addressed, especially for women living in low-income and middle-income countries (LMICs) where this burden of disease is the highest. The objective of this scoping review is to map existing evidence in LMICs on (a) Study designs and data sources, (b) Context-relevant definitions and descriptions, (c) Associated risk and protective factors, (d) Relevant maternal and infant health outcomes and (e) Treatments and interventions used to manage multiple long-term conditions before, during and after pregnancy.

Methods and analysis

This scoping review will be conducted using Joanna Briggs Institute methodology and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement extension for scoping reviews. This review will include observational, experimental or quasi-experimental studies, as well as systematic or umbrella reviews, on multimorbidity in women of reproductive age (15–49 years) in prepregnancy, pregnancy or up to 6 weeks after childbirth in LMICs. The studies will focus on definitions, risk and protective factors and management strategies for multiple long-term conditions before, during and after pregnancy. Studies of morbidity in women with a single index condition or conditions that are not related to pregnancy or childbirth will be excluded. A search strategy will be developed using thesaurus (including MeSH) and free-text terms for ‘maternal morbidity’ or ‘multiple long-term conditions’ and associated keywords such as multimorbidity, co-morbidity and unmet health needs related to pregnancy and/or childbirth for women living in LMICs. Electronic (EBSCOhost (CINAHL Ultimate, STM Source, Medline Ultimate), Cochrane Library, Web of Science or Scopus and Google Scholar) and grey literature databases will be searched from database inception. Reference lists and bibliographies of key topic articles will also be searched, and any additional papers that meet the inclusion criteria will be obtained. There will be no limitations on dates or languages. Records will be independently screened, selected and extracted by two researchers. Data will be presented in tables and narrative summaries.

Ethics and dissemination

Ethics approval is not required as this scoping review will summarise previously published data. Findings from the review will be disseminated through various platforms, including peer-reviewed journals, conferences and community meetings.

Study registration

Open Science Framework (https://doi.org/10.17605/OSF.IO/FYCR8).

☐ ☆ ✇ Journal of Clinical Nursing

How Nurses' Interventions Promote Health Literacy in Patients With Non‐Communicable Diseases: A Systematic Review

ABSTRACT

Background

More than one-third of all diseases in the world are non-communicable diseases (NCDs), and poorer health outcomes are linked to low health literacy (HL), in which nurses have a significant role to play. Various studies have confirmed that there is an association between HL and NCDs. However, less is known about how nurses can intervene in the development of HL in patients with NCDs. This systematic review was carried out to explore, in a comprehensive way, nursing interventions that could promote HL in patients with NCDs.

Methods

A systematic review (PROSPERO registration number: CRD370625) was carried out on five databases (PubMed MEDLINE, Web of Science, Scopus, ScienceDirect and JSTOR). Sequences that provided information for our study topic were retrieved and analysed following PRISMA guidelines for systematic reviews.

Results

In total, 1915 titles and abstracts were screened, 71 articles were assessed in full-text screening and 25 studies were included in the review. Around 23 different nurse-led intervention strategies were identified, but only 11 major ones were explored in detail. The majority of them prioritised communication (teach-back), self-management programs, counselling and education. In the majority of the trials, a significant positive outcome was discovered. Both nurses and patients needed to devote time and attention to the complex nurse-led HL interventions.

Conclusion

Nurses' HL interventions have shown promise in promoting HL and other health outcomes in people with NCDs, but they need to be tailored to fit specific patients. Nursing programs should include more than just patient teaching strategies.

Relevance to Clinical Practice

Nurses' HL efforts hold potential for enhancing HL in NCD patients, provided they are customised to individual needs.

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