Mobile App-Based Interventions to Support Maternal Roles in Child Nutrition and Development: A Scoping Review

Introduction

Early childhood is a critical period for growth, brain development, and the establishment of health-related behaviors that influence lifelong outcomes. The first five years of life, particularly the first 1000 days from conception to age two, are foundational for long-term cognitive, emotional, and physical health.^1,2 During this sensitive window, mothers and primary female caregivers are central agents in shaping a child’s nutrition, development, and overall well-being.^3,4 Maternal knowledge, attitudes, and confidence directly affect child outcomes such as exclusive breastfeeding, dietary adequacy, and responsive caregiving.^5,6 Empowering mothers with timely, accurate, and actionable information is therefore essential to prevent developmental delays and malnutrition, especially in resource-constrained settings.

Digital health technologies have emerged as a promising strategy to address gaps in maternal and child health service delivery. Tools such as SMS, teleconsultation, decision-support algorithms, and mobile applications offer new avenues to support maternal practices.⁷ Among these, mobile applications are particularly well-suited for promoting maternal roles due to their capacity to provide interactive, multimedia-rich, and personalized content. Mobile apps can deliver real-time feedback, track behaviors, provide peer and expert support, and offer structured educational modules, all of which have been linked to improved caregiving and feeding practices.^6,8 Their scalability, offline functionality, and increasing global smartphone penetration make app-based interventions relevant across urban and rural contexts.

Although several reviews have examined digital health strategies in maternal and child health, most focus broadly on mHealth, combining diverse modalities such as SMS, interactive voice response, telehealth, and apps, which can obscure the specific mechanisms and benefits of mobile applications.^9,10 Few studies have explicitly addressed how mobile apps enhance maternal roles in child nutrition and development, particularly in terms of behavior change, decision-making, and psychosocial empowerment.

To address this gap, this scoping review aims to identify, map, and thematically analyze mobile app–based interventions targeting maternal engagement in child nutrition and early development. This review also examines the scope, functionality, and outcomes of these interventions while considering implementation processes, user engagement, and contextual relevance across diverse populations. By consolidating current evidence, this study seeks to inform the design of future digital tools, guide research priorities, and support policies that advance maternal and child health equity.

Methods

Study Design and Framework

This scoping review systematically identified, categorized, and synthesized evidence on mobile application–based digital health interventions supporting maternal roles in early childhood nutrition and development. The review focused on how mobile apps enhance maternal practices, including child feeding, nutritional decision-making, and stimulation activities for children aged 0–5 years. The methodological framework followed Arksey and O’Malley’s five-stage process (2005): (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) data charting, and (5) collating, summarizing, and reporting the results. Enhancements recommended by Levac et al,¹¹ including iterative team discussions, were incorporated to improve rigor. The review adhered to the PRISMA-ScR checklist to ensure transparency and reproducibility.¹²

Eligibility Criteria

Eligibility was defined using the Population–Concept–Context (PCC) framework from the Joanna Briggs Institute.

• Population: mothers or female caregivers of children aged 0–5 years.
• Concept: mobile application–based interventions aimed at improving maternal behaviors related to child nutrition and development.
• Context: both high- and low-resource settings.

Inclusion Criteria

Primary research (qualitative, quantitative, mixed methods), focus on mobile app interventions for maternal roles in child feeding, nutrition, or early development, full text in English, published between January 2013 and May 2025. Grey literature with methodological detail was included. Exclusion criteria: editorials, reviews, conference abstracts, opinion papers, and non-app mHealth interventions (eg, SMS-only, teleconsultation).

Information Sources and Search Strategy

Five databases were searched: PubMed, Scopus, Web of Science, CINAHL, and PsycINFO. Grey literature was sourced from Google Scholar, WHO Digital Health Atlas, UNICEF innovation databases, and relevant NGO repositories. Reference lists of included studies were also screened. Search strategies combined MeSH and free-text terms for maternal behavior, child nutrition, early development, and mobile applications, tailored to each database. Filters included English language and publication years 2013–2025. Final search: May 12, 2025. Detailed search strategies are in Supplementary Table S1.

Study Selection Process

Two-stage screening was performed. Duplicates were removed, then titles and abstracts screened. Full texts were assessed independently by two reviewers using Rayyan. Discrepancies were resolved by discussion, with a third reviewer consulted if needed. Screening is documented in a PRISMA-ScR flowchart.

Data Charting Process

A standardized charting form captured study characteristics, participant demographics, study design, intervention features, and maternal/child outcomes. Additional data included user engagement, technological components, cultural adaptation, and implementation factors. Data extraction was conducted independently by two reviewers, with discrepancies resolved through consensus. Descriptive patterns were analyzed; no meta-analysis was performed due to heterogeneity.

Methodological Quality Assessment

Interpretive assessment of methodological rigor was conducted using design-appropriate tools: Joanna Briggs Institute (JBI) checklists and the Mixed Methods Appraisal Tool (MMAT). Domains assessed included selection, performance, detection, attrition, and reporting bias, rated as low, moderate, or high. Two reviewers conducted assessments independently, with a third reviewer consulted if needed.

Synthesis of Results

Quantitative and qualitative data were synthesized descriptively. Thematic analysis identified patterns in intervention components, maternal behavior change strategies, and child health outcomes. Findings are presented narratively.

Ethical Considerations

No human participants or primary data were involved; all sources were publicly available. Ethical approval was not required.

Results

Search Results

The initial search across five databases and grey literature sources yielded 1756 records. After removing 523 duplicates, 1233 records were screened at the title and abstract level, of which 1102 were excluded for not meeting inclusion criteria. A total of 131 full-text articles were retrieved; 15 could not be obtained, leaving 116 for full-text assessment. During eligibility screening, 91 studies were excluded due to irrelevant population (n = 28), non-aligned intervention scope (n = 24), inappropriate context (n = 16), or unsuitable study design (n = 23). Ultimately, 25 studies met all inclusion criteria. Inter-rater agreement was high (Cohen’s kappa = 0.82). The selection process is illustrated in the PRISMA-ScR flow diagram (Figure 1).

Figure 1 PRISMA 2020 flow diagram of the study selection process. The diagram illustrates the process of study identification, screening, eligibility assessment, and inclusion in accordance with the PRISMA 2020 guidelines. Records were identified through database searching and other sources, duplicates were removed, titles and abstracts were screened, full-text articles were assessed for eligibility, and the final studies were included in the review.

Characteristics of Included Studies

The 25 studies were conducted in high-income and low- to middle-income countries, with most published between 2015 and 2024. Study designs included 11 quantitative studies (randomized controlled trials, quasi-experimental), 7 qualitative studies, and 7 mixed-methods studies. Sample sizes ranged from fewer than 30 participants to over 500. Most interventions targeted mothers of children under 2 years, with some including caregivers of children up to 5 years. Key study characteristics are summarized in Table 1.

Table 1 Characteristics of Included Studies

Intervention Characteristics

All interventions were delivered via mobile applications, with some integrating SMS reminders or multimedia components. Common app features included:

• Educational modules on breastfeeding, complementary feeding, responsive parenting, and child stimulation
• Real-time feedback based on input from users (eg, feeding logs, child growth data)
• Tracking tools, including growth charts, feeding diaries, and immunization reminders
• Social or peer support functions, such as community chat groups or forums moderated by healthcare professionals.
• Gamification elements to promote engagement and adherence

Several interventions were co-designed with end users to improve cultural relevance and usability, particularly for underserved populations. Objectives varied, including extending breastfeeding duration, promoting responsive feeding, supporting growth monitoring, enhancing maternal self-efficacy, and promoting early stimulation.

Outcomes

Outcomes were consistently positive across four main domains (Table 1):

1. Maternal Knowledge and Behavior:Increased knowledge of infant feeding, higher confidence in caregiving, and improved responsive feeding practices.
2. Child Health and Developmental Outcomes:
   • Longer breastfeeding duration (e.g,³²)
   • Better anthropometric outcomes (e.g,¹⁶)
   • Early identification of developmental delays²⁸
3. Developmental Gains:Modest improvements in cognitive, motor, and socioemotional development; integration of milestone tracking with targeted educational messages.
4. Service Utilization:Increased attendance at growth monitoring and immunization sessions; better adherence to national nutrition programs.

Implementation and Engagement

Successful interventions incorporated culturally tailored content, co-design with users, interactive features (eg, gamification, personalized feedback), and human support components such as healthcare professionals or trained peer counselors. These elements promoted sustained app use and user satisfaction. Key barriers included limited digital literacy, inconsistent internet access, language or cultural mismatches, and concerns over long-term sustainability (Table 2).

Table 2 Summary of Findings

Risk of Bias

Methodological quality was generally acceptable Most studies demonstrated low to moderate overall risk of bias, with one study rated high risk.⁷ Low-risk studies exhibited robust participant selection, intervention delivery, outcome measurement, and reporting.^33–35 Moderate-risk studies were affected by performance or attrition bias,^15,19,28 and one study had high overall risk due to evaluation of commercial apps without controlled conditions. Reporting bias was minimal across studies, supporting confidence in outcome validity (Figure 2).

Figure 2 Risk of bias distribution for each indicator across the 25 included studies. The figure presents the proportion of studies rated as low risk, high risk, or unclear risk of bias for each methodological domain assessed. The distribution reflects the overall methodological quality across the included studies.

Summary

Overall, mobile app-based interventions improved maternal behaviors, child nutrition, and developmental outcomes, while highlighting the importance of implementation quality, user engagement, and context-specific adaptations to maximize effectiveness.

Discussion

This scoping review mapped the current evidence on mobile applications designed to support maternal behaviors in promoting child nutrition and development, directly addressing the study’s objective of identifying app-based strategies, their functionalities, and their outcomes across diverse populations. Across the 25 included studies, mobile applications consistently improved maternal knowledge, confidence, and responsive feeding practices, as well as child nutrition and developmental outcomes. These findings confirm the potential of digital interventions to enhance maternal roles in early childhood health, aligning with the review’s aim of evaluating both behavioral and developmental impacts.

Unlike earlier reviews focusing narrowly on breastfeeding,⁶ or digital parenting interventions.³⁶ This study integrates maternal behavior change strategies, app functionalities, implementation processes, and child-level outcomes. Prior reviews largely emphasized usability or effectiveness without examining contextual factors, co-design processes, or equity considerations. By including studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), this review extends the evidence base, providing a more nuanced understanding of how mobile applications operate in different contexts.^16,17

Interventions in HICs often leveraged high smartphone penetration, stable internet access, and advanced app features such as interactive gamification, sophisticated feedback algorithms, and integration with electronic health records.^37,38 These studies reported strong improvements in maternal behaviors and developmental outcomes, particularly in well-resourced urban populations. In contrast, interventions in LMICs faced challenges such as limited digital literacy, intermittent internet connectivity, and cultural or language mismatches. Despite these barriers, apps that incorporated co-design, culturally tailored content, peer support, and offline capabilities still achieved meaningful improvements in maternal behaviors and child nutrition.³⁹ This comparison underscores the importance of contextual adaptation, showing that even resource-constrained settings can benefit from mobile applications when interventions are carefully designed to meet local needs.

Across contexts, successful interventions combined interactive content, real-time feedback, milestone tracking, and human support components (eg, healthcare professionals or peer counselors). These features promoted sustained engagement, particularly among populations with limited access to conventional maternal and child health services. Barriers to implementation included low digital literacy, connectivity issues, and sustainability concerns in donor-funded programs. These findings highlight that app design alone is insufficient; human support and health system integration are essential to maximize adoption and impact.

By including quantitative, qualitative, and mixed-methods studies, this review provides a holistic understanding of mobile application interventions and their contextual use. Limitations include small sample sizes, short follow-up periods, inconsistent engagement measures, and lack of standardized outcomes, which constrain comparability across studies. Few studies addressed potential unintended consequences, such as misinformation, privacy concerns, or screen time overexposure.

This review emphasizes the potential of mobile applications to enhance maternal behaviors and child health outcomes across diverse contexts. Future research should focus on long-term effectiveness, scalability, cost-effectiveness, and digital equity, particularly in LMICs. Contextual adaptation, co-design with end users, and integration into existing health systems remain critical for achieving sustainable impact.

Mobile applications represent a versatile and promising approach to supporting maternal roles in child nutrition and development. When contextually adapted and coupled with implementation support, these interventions can promote positive behavioral and developmental outcomes, addressing both immediate needs and long-term health equity goals in both high- and low-/middle-income countries.

Strength and Limitation

This review also has several strengths. It included a wide range of study designs including qualitative, quantitative, and mixed-methods that enabling a rich understSilwanah ng of both outcomes and implementation processes. The diversity of target populations across contexts enhances the generalizability of findings. However, limitations were noted. Small sample sizes and inconsistent definitions of user engagement reduced comparability between studies. Moreover, few studies employed standardized outcome measures or evaluated long-term health impacts.

Implications for Practice, Research, and Policy

mHealth applications can serve as complementary tools to in-person care, especially in settings where healthcare resources are limited. Integration into existing maternal and child health services, supported by community health workers, can help extend the reach of evidence-based care. However, interventions must be tailored to users’ cultural, linguistic, and technological contexts, particularly among populations with limited digital literacy. There is a critical need for long-term studies to evaluate the sustained effects of mHealth tools on maternal practices and child outcomes. Additionally, cost-effectiveness analyses are crucial for informing decisions about scaling up these interventions in resource-limited settings. Future studies should explore personalization strategies that adapt interventions to demographic, behavioral, and cultural factors. Governments and public health agencies have a window of opportunity to invest in digital health infrastructure, including affordable mobile access and regulatory frameworks for quality assurance. National digital health strategies should explicitly incorporate maternal and child health priorities and set standards to ensure that mHealth tools are evidence-based, user-centered, and free from misleading or harmful content.

Conclusion

This scoping review identified and mapped 25 studies involving mobile health interventions aimed at supporting maternal roles in early childhood nutrition and development. The findings suggest that mHealth applications can effectively enhance maternal practices, including breastfeeding, dietary decision-making, and developmental stimulation, thereby contributing to improved child health outcomes. The diversity of interventions and target populations suggests that mobile tools are adaptable across various settings, including underserved communities. However, successful implementation depends on addressing challenges such as digital access, user engagement, and sustainability. Further high-quality studies are needed to examine the long-term effectiveness, integration with existing health services, and cost-effectiveness of digital interventions in real-world conditions. As digital health technologies continue to evolve, they hold significant potential to advance maternal and child health equity, particularly in low-resource contexts.