Understanding the implementation (including women’s use) of maternity waiting homes in low-income and middle-income countries: a realist synthesis protocol

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Understanding the implementation (including women’s use) of maternity waiting homes in low-income and middle-income countries: a realist synthesis protocol


JournalBMJ Open
Article typeJournal research article – Clinical research
Publication date – Mar – 2021
Authors – Daphne N McRae, Anayda Portela, Tamara Waldron, Nicole Bergen, Nazeem Muhajarine
Keywordsfetal medicine, international health services, maternal medicine, public Health
Open access – Yes
SpecialityHealth policy, Obstetrics and Gynaecology
World region Global

Language – English
Submitted to the One Surgery Index on March 28, 2021 at 7:52 am
Abstract:

Introduction
Maternity waiting homes in low-income and middle-income countries provide accommodation near health facilities for pregnant women close to the time of birth to promote facility-based birth and birth with a skilled professional and to enable timely access to emergency obstetric services when needed. To date, no studies have provided a systematic, comprehensive synthesis explaining facilitators and barriers to successful maternity waiting home implementation and whether and how implementation strategies and recommendations vary by context. This synthesis will systematically consolidate the evidence, answering the question, ‘How, why, for whom, and in what context are maternity waiting homes successfully implemented in low-income and middle-income countries?’.

Methods and analysis
Methods include standard steps for realist synthesis: determining the scope of the review, searching for evidence, appraising and extracting data, synthesising and analysing the data and developing recommendations for dissemination. Steps are iterative, repeating until theoretical saturation is achieved. Searching will be conducted in 13 electronic databases with results managed in Eppi-Reviewer V.4. There will be no language, study-type or document-type restrictions. Items documented prior to 1990 will be excluded. To ensure our initial and revised programme theories accurately reflect the experiences and knowledge of key stakeholders, most notably the beneficiaries, interviews will be conducted with maternity waiting home users/nonusers, healthcare staff, policymakers and programme designers. All data will be analysed using context–mechanism–outcome configurations, refined and synthesised to produce a final programme theory.

Ethics and dissemination
Ethics approval for the project will be obtained from the Mozambican National Bioethical Commission, Jimma University College of Health Sciences Institutional Review Board and the University of Saskatchewan Bioethical Research Ethics Board. To ensure results of the evaluation are available for uptake by a wide range of stakeholders, dissemination will include peer-reviewed journal publication, a plain-language brief, and conference presentations to stakeholders’ practice audiences.

OSI Number – 20988
PMID – 33658257

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