ENHANCING ENVIRONMENTAL HEALTH LITERACY AMONG PREGNANT WOMEN THROUGH GAMIFIED DIGITAL LEARNING: A SYSTEMATIC REVIEW

Abstract

Background: Maternal child health is an underlying public health concern in low- income countries, where environmental hazards such as poor sanitation, ill-waste management, and limited access to clean water are threats to the health of mothers. Despite advancements in digitalization in healthcare, the application of environmental health literacy (EHL) in digital maternal education remains minimal. Object: : The research aimed to identify, review, and synthesize evidence about digital health literacy interventions in pregnant women— specifically, mobile and game-based applications—that promote learning environmental health as well as changing behavior. Methods: Systematic literature review was conducted following the PRISMA guidelines. Fourteen empirical studies from 2019 to 2024 were obtained from Scopus, PubMed, and Google Scholar databases. Narrative synthesis was used to synthesize the studies and compare them descriptively to identify effective design features and outcomes. Results: Findings from the research point out that gamified mobile health interventions significantly encourage knowledge, motivation, and behavior adoption regarding hygiene, sanitation, and environmental management. Interventions coupled with gamification and community empowerment factors such as conversation between peers and feedback by midwives showed higher involvement and sustained behavior change. Incorporation of EHL content into digital resources extended the users' understanding from personal hygiene to environmental stewardship, incorporating collective health awareness. Conclusion: Community-based and gamified digital health literacy programs have strong potential to improve environmental health literacy and maternal hygiene practices significantly. The findings support the potential of gamified, culturally relevant mobile applications to help Indonesia's digital transformation agenda, community empowerment, and environmental sustainability in maternal health education.