Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
Department of Epidemiology, Biostatistics and Occupational Health, Purvis Hall, McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada.
Soc Sci Med. 2022 Jan;292:114629. doi: 10.1016/j.socscimed.2021.114629. Epub 2021 Dec 3.
Indigenous women world-wide are diverse and heterogenous, yet many have similar experiences of colonization, land dispossession, and discrimination. These experiences along with inequitable access to, and quality of, maternal healthcare increase adverse maternal health outcomes. To improve health outcomes for Indigenous women, studies must be conducted with Indigenous involvement and reflect Indigenous research principles. Objectives/Aim: The aim of this review was to explore the range, extent, and nature of Indigenous maternal health research and to assess the reporting of Indigenous research principles in the global Indigenous maternal health literature.
Following a systematic scoping review protocol, four scholarly electronic databases were searched. Articles were included if they reported empirical research published between 2000 and 2019 and had a focus on Indigenous maternal health. Descriptive data were extracted from relevant articles and descriptive analysis was conducted. Included articles were also assessed for reporting of Indigenous research principles, including Indigenous involvement, context of colonization, Indigenous conceptualizations of health, community benefits, knowledge dissemination to participants or communities, and policy or intervention recommendations.
Four-hundred and forty-one articles met the inclusion criteria. While studies were conducted in all continents except Antarctica, less than 3% of articles described research in low-income countries. The most researched topics were access to and quality of maternity care (25%), pregnancy outcome and/or complications (18%), and smoking, alcohol and/or drug use during pregnancy (14%). The most common study design was cross-sectional (49%), and the majority of articles used quantitative methods only (68%). Less than 2% of articles described or reported all Indigenous research principles, and 71% of articles did not report on Indigenous People's involvement.
By summarizing the trends in published literature on Indigenous maternal health, we highlight the need for increased geographic representation of Indigenous women, expansion of research to include important but under-researched topics, and meaningful involvement of Indigenous Peoples.
世界各地的土著妇女具有多样性和异质性，但许多人都经历过殖民、土地剥夺和歧视。这些经历以及获得和享受孕产妇保健服务的机会不平等，导致孕产妇健康状况恶化。为了改善土著妇女的健康状况，必须在土著人民的参与下进行研究，并反映土著研究原则。
本综述的目的是探讨全球土著孕产妇健康文献中土著孕产妇健康研究的范围、程度和性质，并评估土著研究原则的报告情况。
根据系统的范围综述方案，对四个学术电子数据库进行了搜索。如果文章报告了 2000 年至 2019 年期间发表的实证研究，且重点是土著孕产妇健康，则将其纳入。从相关文章中提取描述性数据，并进行描述性分析。还评估了纳入的文章，以报告土著研究原则，包括土著人民的参与、殖民化背景、土著人民对健康的概念化、社区受益、向参与者或社区传播知识以及政策或干预建议。
有 441 篇文章符合纳入标准。虽然研究在除南极洲以外的所有大陆进行，但不到 3%的文章描述了低收入国家的研究。研究最多的主题是获得和质量产妇保健（25%）、妊娠结局和/或并发症（18%）和吸烟、饮酒和/或怀孕期间使用毒品（14%）。最常见的研究设计是横断面研究（49%），大多数文章仅使用定量方法（68%）。不到 2%的文章描述或报告了所有土著研究原则，71%的文章没有报告土著人民的参与情况。
通过总结关于土著孕产妇健康的已发表文献中的趋势，我们强调需要增加土著妇女在地理上的代表性，扩大研究范围，包括重要但研究不足的主题，并使土著人民有意义地参与进来。
