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Reprod Health. 2018 Oct 10;15(1):169. doi: 10.1186/s12978-018-0588-2.

A systematic review of person-centered care interventions to improve quality of facility-based delivery.

Author information

1
Institute for Global Health Sciences, University of California, San Francisco, Mission Hall, Box 1224, 550 16th Street, Third Floor, San Francisco, CA, 94158, USA. nicholas.rubashkin@ucsf.edu.
2
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, USA. nicholas.rubashkin@ucsf.edu.
3
Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, Zuckerberg San Francisco General, University of California, San Francisco, 1001 Potrero Avenue, 6D, San Francisco, CA, 94110, USA.
4
Institute for Global Health Sciences, University of California, San Francisco, Mission Hall, Box 1224, 550 16th Street, Third Floor, San Francisco, CA, 94158, USA.
5
Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, Mission Hall, Box 1224, 550 16th Street, Third Floor, San Francisco, CA, 94158, USA.

Abstract

INTRODUCTION:

We conducted a systematic review to summarize the global evidence on person-centered care (PCC) interventions in delivery facilities in order to: (1) map the PCC objectives of past interventions (2) to explore the impact of PCC objectives on PCC and clinical outcomes.

METHODS:

We developed a search strategy based on a current definition of PCC. We searched for English-language, peer-reviewed and original research articles in multiple databases from 1990 to 2016 and conducted hand searches of the Cochrane library and gray literature. We used systematic review methodology that enabled us to extract and synthesize quantitative and qualitative data. We categorized interventions according to their primary and secondary PCC objectives. We categorized outcomes into person-centered and clinical (labor and delivery, perinatal, maternal mental health).

RESULTS:

Our initial search strategy yielded 9378 abstracts; we conducted full-text reviews of 32 quantitative, 6 qualitative, 2 mixed-methods studies, and 7 systematic reviews (Nā€‰=ā€‰47). Past interventions pursued these primary PCC objectives: autonomy, supportive care, social support, the health facility environment, and dignity. An intervention's primary and secondary PCC objectives frequently did not align with the measured person-centered outcomes. Generally, PCC interventions either improved or made no difference to person-centered outcomes. There was no clear relationship between PCC objectives and clinical outcomes.

CONCLUSIONS:

This systematic review presents a comprehensive analysis of facility-based delivery interventions using a current definition of person-centered care. Current definitions of PCC propose new domains of inquiry but may leave out previous domains.

KEYWORDS:

Conceptual frameworks; Facility-based childbirth; Interventions; Systematic review, person-centered care, respectful maternity care

PMID:
30305129
PMCID:
PMC6180507
DOI:
10.1186/s12978-018-0588-2
[Indexed for MEDLINE]
Free PMC Article

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