Ven Champamunny, Marella Manjula, Vaughan Cathy, Slade Sian, Devine Alexandra
Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
Midwifery. 2025 Apr;143:104321. doi: 10.1016/j.midw.2025.104321. Epub 2025 Jan 31.
Current evidence highlights that women with disabilities experience challenges in accessing maternity care. Improving access requires an understanding of the factors influencing the capacity of healthcare providers to provide disability-inclusive care. Although providing maternity care services for women with disabilities has been reported to be a rewarding experience, numerous factors may impact health care providers' capacity to do so. Limited evidence, especially from low and middle-income countries (LMICs), undermines our understanding of this issue and how to respond. This scoping review, therefore, aims to synthesise the current published literature examining factors influencing the capacity of healthcare providers to deliver disability-inclusive maternity care services.
This scoping review used the Arksey and O'Malley framework in accordance with the PRISMA extension for Scoping Reviews. A systemic search of six electronic databases, including MEDLINE (Ovid), CINAHL Complete, Scopus, Eric Ebsco, Web of Science Core Collection, and EMBASE (Ovid), was undertaken to identify relevant studies. Snowball searching of reference lists and citations was also performed. The Quality of Care Framework for Maternal and Newborn Health, developed by the World Health Organization, was employed to guide the analysis and synthesis of the findings of this review.
Twenty-four studies published between 2000 and 2023 met the inclusion criteria. Factors influencing the capacity of healthcare providers to provide disability-inclusive maternity care were identified and categorised into six domains aligning with the Quality of Care framework: 1) Evidence-based practices for routine care and management of complications; 2) Actionable information systems; 3) Effective communication; 4) Respect and dignity; 5) Competent and motivated human resources; and 6) Essential physical resources available.
This scoping review synthesised evidence on six key factors affecting the capacity of healthcare providers to provide disability-inclusive maternity care. It highlights the need to address the limited application of a 'disability lens' to evidence-based guidelines and health information. The review also highlights the need to better enable healthcare providers at all stages of their training and clinical practice to develop their knowledge and skills in providing respectful, disability-inclusive maternity care, in addition to ensuring essential physical resources are available. Very few studies examine the capacity of healthcare providers in low- and middle-income countries. Future research should focus on developing context-specific evidence from such countries, particularly given that this is where the majority of women with disabilities live.
当前证据表明，残疾女性在获得孕产护理方面面临挑战。改善可及性需要了解影响医疗服务提供者提供包容残疾护理能力的因素。尽管据报道为残疾女性提供孕产护理服务是一次有益的经历，但众多因素可能会影响医疗服务提供者这样做的能力。证据有限，尤其是来自低收入和中等收入国家（LMICs）的证据，削弱了我们对这一问题以及如何应对的理解。因此，本范围综述旨在综合当前已发表的文献，研究影响医疗服务提供者提供包容残疾孕产护理服务能力的因素。
本范围综述采用了符合PRISMA扩展版范围综述的阿克西和奥马利框架。对六个电子数据库进行了系统检索，包括MEDLINE（Ovid）、CINAHL Complete、Scopus、Eric Ebsco、Web of Science核心合集和EMBASE（Ovid），以确定相关研究。还对参考文献列表和引文进行了滚雪球式检索。采用世界卫生组织制定的孕产妇和新生儿健康护理质量框架来指导本综述结果的分析和综合。
2000年至2023年间发表的24项研究符合纳入标准。确定了影响医疗服务提供者提供包容残疾孕产护理能力的因素，并根据护理质量框架分为六个领域：1）常规护理和并发症管理的循证实践；2）可操作的信息系统；3）有效的沟通；4）尊重和尊严；5）有能力且积极主动的人力资源；6）可用的基本物质资源。
本范围综述综合了关于影响医疗服务提供者提供包容残疾孕产护理能力的六个关键因素的证据。它强调需要解决在循证指南和健康信息中“残疾视角”应用有限的问题。该综述还强调，除了确保提供基本物质资源外，还需要在医疗服务提供者培训和临床实践的各个阶段更好地使其发展提供尊重残疾、包容残疾孕产护理的知识和技能。很少有研究考察低收入和中等收入国家医疗服务提供者的能力。未来的研究应侧重于从这些国家获取针对具体情况的证据，特别是考虑到大多数残疾女性生活在这些国家。
