Anderson Rondi, Zaman Sojib Bin, Limmer Mark
The Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK.
Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne 3800, Australia.
Methods Protoc. 2023 May 5;6(3):48. doi: 10.3390/mps6030048.
Midwives have the potential to significantly contribute to health-delivery systems by providing sexual, reproductive, maternal, newborn, and adolescent health (SRMNAH) care. However, scant research finds barriers to understanding what midwives need to realize their full potential. There are gaps in the definition of a midwife and an understanding of effective means to support the implementation of midwifery care. Mentorship has been found to support systems and healthcare providers to improve care availability and quality.
We describe the methodology of an integrative review that aims to generate evidence of the impact of introducing midwives and also on-site facility mentoring to better understand facilitators and barriers to implementation of the quality and availability of SRMNAH services in low- and middle-income countries (LMICs).
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be used to carry out the integrative review. Four electronic bibliographic databases, PubMed MEDLINE, EMBASE, Scopus, and CINAHL, will be used to identify eligible studies. All types of qualitative or quantitative studies will be considered. Eligible studies will be screened according to Population, Intervention, Comparison, and Outcome (PICO) inclusion criteria, and data will be extracted against a predetermined format. The aspects of health system strengthening in providing improved SRMNCH care will be examined in this review to generate evidence on how midwives and mentorship can improve routine care and health outcomes using the World Health Organization's Six Building Blocks approach. The quality of the articles will be thematically analyzed in four areas: coherence and integrity, appropriateness for answering the question, relevance and focus, and overall assessment using the Gough weight-of-evidence framework.
The literature review will consider assessing both upstream health systems regulators and downstream effectors for implementing midwifery interventions. Within this building block framework, this research will report on the outcomes and experiences of introducing midwives and the effectiveness of mentoring midwives and other staff in midwives' roles in improving care quality and health outcomes.
助产士有潜力通过提供性健康、生殖健康、孕产妇、新生儿和青少年健康（SRMNAH）护理，为卫生服务系统做出重大贡献。然而，鲜有研究发现阻碍理解助产士充分发挥潜力所需条件的因素。在助产士的定义以及对支持助产护理实施的有效手段的理解方面存在差距。已发现指导可支持卫生系统和医疗服务提供者提高护理的可及性和质量。
我们描述一项综合综述的方法，该综述旨在生成引入助产士以及现场机构指导的影响的证据，以更好地理解在低收入和中等收入国家（LMICs）实施SRMNAH服务的质量和可及性的促进因素和障碍。
将使用系统评价和Meta分析的首选报告项目（PRISMA）指南进行综合综述。将使用四个电子书目数据库，即PubMed MEDLINE、EMBASE、Scopus和CINAHL来识别符合条件的研究。将考虑所有类型的定性或定量研究。符合条件的研究将根据人群、干预措施、对照和结果（PICO）纳入标准进行筛选，并将根据预定格式提取数据。本综述将研究加强卫生系统以提供更好的SRMNCH护理的各个方面，以生成关于助产士和指导如何使用世界卫生组织的六大要素方法改善常规护理和健康结果的证据。将使用Gough证据权重框架，在四个领域对文章质量进行主题分析：连贯性和完整性、回答问题的适当性、相关性和重点以及总体评估。
文献综述将考虑评估实施助产干预措施的上游卫生系统监管者和下游执行者。在此要素框架内，本研究将报告引入助产士的结果和经验，以及指导助产士和其他工作人员在助产士角色中改善护理质量和健康结果的有效性。
