Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review.

Globally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a glob...

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Main Authors: Bahareh Goodarzi, Annika Walker, Lianne Holten, Linda Schoonmade, Pim Teunissen, François Schellevis, Ank de Jonge
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0234252
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author Bahareh Goodarzi
Annika Walker
Lianne Holten
Linda Schoonmade
Pim Teunissen
François Schellevis
Ank de Jonge
author_facet Bahareh Goodarzi
Annika Walker
Lianne Holten
Linda Schoonmade
Pim Teunissen
François Schellevis
Ank de Jonge
author_sort Bahareh Goodarzi
collection DOAJ
description Globally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a global necessity to ensure women and children receive appropriate care, at the right place and the right time. Poor conceptualization of risk selection impedes evaluation and comparison of models of risk selection across various settings, which is necessary to improve maternal and newborn care. We conducted a scoping review to enhance the understanding of risk selection in maternal and newborn care. We included 210 papers, published over the past four decades, originating from 24 countries. Using inductive thematic analysis, we identified three main dimensions of risk selection: (1) risk selection as an organisational measure to optimally align women's and children's needs and resources, (2) risk selection as a practice to detect and assess risk and to make decisions about the delivery of care, and (3) risk selection as a tool to ensure safe care. We found that these three dimensions have three themes in common: risk selection (1) is viewed as both requiring and providing regulation, (2) has a provider centred focus and (3) aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make cross-setting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women's needs, and unnecessary medicalization.
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spelling doaj.art-49edb57a83374a6fa3096e1787d8c59a2022-12-21T18:39:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01156e023425210.1371/journal.pone.0234252Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review.Bahareh GoodarziAnnika WalkerLianne HoltenLinda SchoonmadePim TeunissenFrançois SchellevisAnk de JongeGlobally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a global necessity to ensure women and children receive appropriate care, at the right place and the right time. Poor conceptualization of risk selection impedes evaluation and comparison of models of risk selection across various settings, which is necessary to improve maternal and newborn care. We conducted a scoping review to enhance the understanding of risk selection in maternal and newborn care. We included 210 papers, published over the past four decades, originating from 24 countries. Using inductive thematic analysis, we identified three main dimensions of risk selection: (1) risk selection as an organisational measure to optimally align women's and children's needs and resources, (2) risk selection as a practice to detect and assess risk and to make decisions about the delivery of care, and (3) risk selection as a tool to ensure safe care. We found that these three dimensions have three themes in common: risk selection (1) is viewed as both requiring and providing regulation, (2) has a provider centred focus and (3) aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make cross-setting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women's needs, and unnecessary medicalization.https://doi.org/10.1371/journal.pone.0234252
spellingShingle Bahareh Goodarzi
Annika Walker
Lianne Holten
Linda Schoonmade
Pim Teunissen
François Schellevis
Ank de Jonge
Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review.
PLoS ONE
title Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review.
title_full Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review.
title_fullStr Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review.
title_full_unstemmed Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review.
title_short Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review.
title_sort towards a better understanding of risk selection in maternal and newborn care a systematic scoping review
url https://doi.org/10.1371/journal.pone.0234252
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