Article Text

Measuring experiences of facility-based care for pregnant women and newborns: a scoping review
  1. Elysia Larson1,2,
  2. Jigyasa Sharma2,
  3. Khalidha Nasiri3,4,
  4. Meghan A Bohren5,
  5. Özge Tunçalp4
  1. 1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  2. 2Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  3. 3Schulich School of Medicine and Dentistry, London, Ontario, Canada
  4. 4Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), WHO, Geneve, Switzerland
  5. 5Centre for Health Equity, University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
  1. Correspondence to Dr Elysia Larson; elarson{at}


Background Access to high-quality, person-centred care during pregnancy and childbirth is a global priority. Positive experience of care is key in particular, because it is both a fundamental right and can influence health outcomes and future healthcare utilisation. Despite its importance for accountability and action, systematic guidance on measuring experience of care is limited.

Methods We conducted a scoping review of published literature to identify measures/instruments for experience of facility-based pregnancy and childbirth (abortion, antenatal, intrapartum, postnatal and newborn) care. We systematically searched five bibliographic databases from 1 January 2007 through 1 February 2019. Using a predefined evidence template, we extracted data on study design, data collection method, study population and care type as reported in primary quantitative articles. We report results narratively.

Results We retrieved 16 528 unique citations, including 171 eligible articles representing, 157 unique instruments and 144 unique parent instruments across 56 countries. Half of the articles (90/171) did not use a validated instrument. While 82% (n=141) of articles reported on labour and childbirth care, only one reported on early pregnancy/abortion care. The most commonly reported sub-domains of user experience were communication (84%, 132/157) and respect and dignity (71%, 111/157). The primary purpose of most papers was measurement (70%, 119/171), largely through cross-sectional surveys.

Conclusion There are alarming gaps in measurement of user experience for abortion, antenatal, postnatal and newborn care, including lack of validated instruments to measure the effects of interventions and policies on user experience.

Protocol registration details This review was registered and published on PROSPERO (CRD42017070867). PROSPERO is an international database of prospectively registered systematic reviews in health and social care.

  • systematic review
  • health services research
  • maternal health

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Supplementary materials


  • EL and JS are joint first authors.

  • Handling editor Seye Abimbola

  • Twitter @ElysiaLarson, @s_jigyasa, @knkhali, khalidhanaIn, @meghanbohren, @otuncalp

  • Correction notice This article has been corrected since it published online to include the missing acknowledgements section.

  • Contributors EL, JS, ÖT and MAB conceived of the study. JS conducted the literature search. EL, JS, MAB and ÖT conducted abstract screening. EL, KN and JS subsequently reviewed full-text articles and extracted data using a standardised form developed for this review. EL and KN cleaned and analysed the data. All authors contributed to data interpretation. EL and JS drafted the manuscript. All authors edited the manuscript and approved of the final version for publication.

  • Funding This review was made possible by the support of the American People through the United States Agency for International Development (USAID) and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, WHO and through the NIH 5T32AI007358-30.

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  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.

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