Immigrant women’s experiences of maternity-care services in Canada: a protocol for systematic review using a narrative synthesis

Abstract

BackgroundCanada’s diverse society and statutory commitment to multiculturalism means that the synthesis of knowledge related to the health care experiences of immigrants is essential to realize the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for tailoring of services to user needs. We are therefore assessing the experiences of immigrant women in Canada accessing maternity-care services. We are focusing on: 1) accessibility and acceptability (as an important dimension of access) to maternity-care services as perceived and experienced by immigrant women, and 2) the birth and postnatal outcomes of these women.MethodsThe aim of this study is to use a narrative synthesis, incorporating both a systematic review using narrative synthesis of reports of empirical research (qualitative, quantitative, and mixed-method designs), and a literature review of non-empirically based reports, both of which include ‘grey’ literature. The study aims to provide stakeholders with perspectives on maternity-care services as experienced by immigrant women. To achieve this, we are using integrated knowledge translation, partnering with key stakeholders to ensure topic relevancy and to tailor recommendations for effective translation into future policy and practice/programming. Two search phases and a three-stage selection process are being conducted (database search retrieved 1487 hits excluding duplicates) to provide evidence to contribute jointly to both the narrative synthesis and the non-empirical literature review. The narrative synthesis will be informed by the previous framework published in 2006 by Popay et al., using identified tools for each of its four elements. The non-empirical literature review will build upon the narrative-synthesis findings and/or identify omissions or gaps in the empirical research literature. The integrated knowledge translation plan will ensure that key messages are delivered in an audience-specific manner to optimize their effect on policy and practice change throughout the health service, and the public health, immigration and community sectors.DiscussionNarrative-synthesis methods of systematic review facilitate understanding and acknowledgement of the broader influences of theoretical and contextual variables, such as race, gender, socioeconomic status, and geographical location. They also enable understanding of the shaping of differences between reported outcomes and study designs related to childbearing populations, and the development and implementation of maternity services and health interventions across diverse settings.PROSPERO registrationNumber 2185.

Immigrant women’s experiences of maternity-care services in Canada: a systematic review using a narrative synthesis

“…All non-empirical publications were used for background or contextual information. The process of selecting grey literature and quality checks is detained in the protocol that published elsewhere [ 44 ].…”

Immigrant women’s experiences of postpartum depression in Canada: a protocol for systematic review using a narrative synthesis

“…The organizations which are represented include Citizenship and Immigration Canada (CIC), Public Health Agency of Canada (PHAC), Alberta Health Services (AHS) and the Multicultural Health Brokers Co-operative (MHBC). The relevance of this project to each organization and IKUs role was described in our previous protocol for another knowledge synthesis project [37]. In addition to using IKUs, a systematic review expert (MM) will help ensure rigor and validity of the findings and recommendations.…”

Which standards from which disciplines? A test of systematic review for designing interdisciplinary evaluations

“…While this was to be expected, as abstract and text appraisals are standard practice for determining relevance in many SRs (Campbell et al 2003;Dixon-Woods et al 2007;Higginbottom et al 2012;Hubbard, Kidd, and Donaghy 2008), such a transparent search for and selection of articles have been noted as wanting in reviews of argument-based literature (McCullough, Coverdale, and Chervenak 2007). We were able to transparently identify, classify, analyse and process prescriptions from a literature that spanned medical and social sciences in a rigorous, comprehensive and transparent manner.…”

“…There has been significant work on qualitative synthesis methodologies (for some examples see Bondas and Hall 2007;Campbell et al 2003;DixonWoods et al 2007;Dixon-Woods et al 2006b;Higginbottom et al 2012;Major and Savin-Baden 2012). We required an analysis method that was reproducible, one that supported conclusions about the real-world practices described in the texts reviewed, and one that brought forward contextual information as that would be relevant to determining when a recommended method would no longer be appropriate.…”