背景:同伴支持已被提议为解决撒哈拉以南非洲(SSA)不良母婴保健(MCH)结局的有希望的政策干预措施。关于同行支持的现有审查主要借鉴了高收入国家的证据,或者侧重于母乳喂养等单一服务,营养或产后护理。相比之下,这篇综述旨在全面概述撒哈拉以南非洲地区各种妇幼保健服务中的同伴支持干预的实证文献.具体来说,我们的目标是了解如何,为什么,为谁,以及在什么情况下,不同形式的妇幼保健同伴支持干预措施有助于改善撒哈拉以南非洲的医疗保健结果。
方法:此审查遵循五个迭代步骤进行现实主义审查(1)定义审查范围;(2)开发初始计划理论;(3)寻找证据;(4)选择和评估证据;(5)提取,分析和合成证据。四个数据库-Cochrane图书馆,PubMed,CINAHL,和EMBASE-在2021年3月至6月之间反复搜索。从数据库和引文搜索中检索到的大量记录中,已选择61篇论文进行审查。在最终提取和合成之前,我们将对2021年6月至今的同一数据库进行第二次搜索。选定论文的最终列表将导入NVivo12软件并进行组织,提取,迭代地分析和综合,以检查和说明上下文之间的因果关系,SSA中MCH同伴支持干预的机制和结果。我们已经借鉴了有关医疗保健中同伴支持的现有文献,以开发初始计划理论。然后,我们将使用关于SSA中MCH同伴支持干预的实证文献,来自加纳利益相关者研讨会和会议演示文稿的投入,以完善初始计划理论。
结论:该综述将发展医疗服务中同伴支持干预的明确理论,并为制定干预措施的循证政策提供见解。从SSA的不同国家背景和MCH的不同领域中吸取教训,审查将提供一个可分析概括的计划理论,可以指导干预设计和实施。在专注于SSA中的MCH同伴支持干预措施的同时,该审查有助于就在全球范围内将理论用于卫生政策规划以及复杂干预措施的设计和实施进行不断发展的对话。
背景:PROSPERO注册ID:CRD42023427751。
Peer support has been proposed as a promising policy intervention for addressing adverse maternal and child healthcare (MCH) outcomes in sub-Saharan Africa (SSA). Existing reviews on peer support largely draw on evidence from high-income countries or focus on single services like breastfeeding, nutrition or postnatal care. In contrast, this
review aims to provide a comprehensive overview of the empirical literature on peer support interventions across various MCH services in sub-Saharan Africa. Specifically, we aim to understand how, why, for whom, and in what circumstances different forms of MCH peer support interventions contribute to improving healthcare outcomes in sub-Saharan Africa.
This
review follows five iterative steps for undertaking realist reviews (1) defining the
review scope; (2) developing initial programme theories; (3) searching for evidence; (4) selecting and appraising evidence; and (5) extracting, analysing and synthesising evidence. Four databases-Cochrane Library, PubMed, CINAHL, and EMBASE-were repeatedly searched between March and June 2021. From a large volume of records retrieved from the database and citation search, 61 papers have been selected for
review. We will conduct a second search of the same database covering June 2021 to the present before the final extraction and synthesis. The final list of selected papers will be imported into NVivo 12 software and organised, extracted, analysed and synthesised iteratively to examine and illustrate the causal links between contexts, mechanisms and outcomes of MCH peer support interventions in SSA. We have drawn on the existing literature on peer support in healthcare generally to develop initial programme theories. We will then use the empirical literature on MCH peer support interventions in SSA, inputs from a stakeholders\' workshop in Ghana and a conference presentation to refine the initial programme theory.
The
review will develop an explicit theory of peer support intervention in healthcare delivery and provide insights for developing evidence-informed policy on the intervention. Drawing lessons from the different national contexts and diverse areas of MCH in SSA, the
review will provide an analytically generalizable programme theory that can guide intervention design and implementation. While focusing on MCH peer support interventions in SSA, the review contributes to evolving conversations on the use of theory for health policy planning and complex intervention design and implementation globally.
PROSPERO registration ID: CRD42023427751 .