Digital health literacy on pregnancy danger signs among pregnant women using mobile health applications: a cross sectional study

A Cross-Sectional Study

Abstract

Introduction: Maternal mortality remains a major public health concern, particularly in low- and middle-income countries (such as Indonesia. Delayed recognition of pregnancy danger signs contributes substantially to preventable maternal deaths. As mobile health (m-Health) platforms increasingly disseminate maternal health information, digital health literacy, the ability to search for, evaluate, and apply online health content, has emerged as a pivotal factor influencing maternal knowledge and decisionmaking. This study aimed to assess the level of digital health literacy among pregnant women, evaluate their knowledge of pregnancy danger signs, and examine the association between digital health literacy and knowledge of danger signs. Methods: A community-based cross-sectional study was conducted among 422 pregnant women recruited through systematic random sampling at primary healthcare centers. Data were collected using structured questionnaires, including the eHealth Literacy Scale and WHO-based pregnancy danger sign items. Data were analysed using SPSS version 26. Results: Overall, 54.5% of participants demonstrated high digital health literacy, while 63.3% had adequate knowledge of pregnancy danger signs. High digital health literacy was significantly associated with better knowledge (aOR=2.81; 95% CI 1.85–4.27; p<0.001). Education also showed a positive association, whereas parity did not emerge as an independent predictor. Conclusions: Digital health literacy plays a crucial role in shaping pregnant women’s awareness of obstetric danger signs. Strengthening it through targeted interventions embedded in antenatal and community health programs may enhance the timely recognition of complications, contributing to reductions in preventable maternal morbidity and mortality.