Search Strategy
A systematic search, selection, and synthesis of existing literature will be used through a scoping review methodology in order to answer the research question. Scoping reviews are a comprehensive and rigorous method aimed at rapidly mapping key concepts underpinning a research area. The review will be guided by the Arksey and O’Malley [24] framework which entails identification of the research question, identification of relevant studies, selection of studies, charting the data, and collating, summarising, and reporting the results. We will also appraise the quality of the included studies as recommended by Levac et al [25].
Identifying the research question
Our research question is: What is the evidence of normative beliefs and values that shape care seeking behaviours for SBA by mothers in Africa?
We have used the Population—Concept—Context (PCC) approach recommended by the Joanna Briggs Institute for scoping reviews [26] to construct a clear and meaningful research question for a scoping review (Table 1.1).
Table 1
POPULATION CONCEPT AND CONTEXT (PCC) FRAMEWORK
Population
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Mothers, women
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Concept
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normative beliefs and values about SBA
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Context
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The context for this study will be Africa
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Identifying relevant studies
We will conduct a comprehensive search of relevant articles from the following electronic databases with articles published between January 2000 and March 2020; Google scholar, PubMed, EBSCOhos, SCOPUS, Embaseand WEB of Science. Further searches will be made on Research gate, including grey literature from university websites for dissertations and theses. We will also search reference lists for relevant articles and studies. Review articles will be excluded. Medical Subject Headings (MeSH) terms that will be included during the search for relevant articlesare:perception, expectation, experience, mothers, women, normative belief, culture, value, norm, tradition, utilization, utilisation, uptake, maternity, delivery, childbirth, sub-Sahara, Africa developing and low- and middle-income country.We will also useBoolean terms, ANDand OR to separate the keywords. Thesearch strategy will be adapted foreach database. For each search conducted, we will documentin detail the date of search, the search engine, and the number ofpublications retrieved.
Pilot Study
A pilot search was conducted in PUBMed and google scholar to determine the feasibility of the research question and search terms using a scoping review method. A preliminary search of articles was done on 28th April and the output of the pilot search is shown on Table 2.
Table 2
Output of the pilot search, April 2020
Date Searched
|
Search Engine
|
Keywords
|
Articles found in the pilot
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22/04/2020
|
PUBMED
|
(perception* OR expectation*OR experience*) AND (mothers* OR women) AND (normative belief * belief* OR culture* OR value* OR norm* OR tradition*) AND (utilization OR utilization OR uptake) AND (maternity OR delivery OR childbirth) AND (sub-sahara* OR africa OR low and middle income country OR developing countries)
|
321
|
22/04/2020
|
Web of Science
|
(perception* OR expectation*OR experience*) AND (mothers* OR women) AND (normative belief * belief* OR culture* OR value* OR norm* OR tradition*) AND (utilization OR utilization OR uptake) AND (maternity OR delivery OR childbirth) AND (sub-sahara* OR africa OR low and middle income country OR developing countries)
|
34
|
22/04/2020
|
Google Scholar
|
(perception* OR expectation*OR experience*) AND (mothers* OR women) AND (normative belief * belief* OR culture* OR value* OR norm* OR tradition*) AND (utilization OR utilization OR uptake) AND (maternity OR delivery OR childbirth) AND (sub-sahara* OR africa OR low and middle income country OR developing countries)
|
4,650
|
Selection of studies
Identification ofappropriate and relevant articles will be guided by selection criteria.
Inclusion criteria
To be included, articles will have to meet the following characteristics:
- Evidence on beliefs and values surroundingchildbirth
- Evidence on perceptions towards facility delivery or skilled health care providers
- Articles published between 2000 and March 2020
- Articles in English
Exclusion criteria
We will exclude the following articles;
- Studies not in English
- Studies with no evidence of mother’s values, beliefs, or norms surroundingchildbirth
- Studies not focused on childbirth or delivery services
- Studies not freely available in full text
All the articles retrieved from the databases will be screened for eligibility through the following stages. In the first stage, the principle investigator (PI) will screen the all the titles for eligibility, and articles that meet the eligibility criteria will be exported to endnote, a referencing software (version 7) used to store and organize citation information. All the titles that are not eligible will be excluded and all the duplicates deleted. In the second stage, the PI and a trained reviewer will independently (in parallel) screen the abstracts from the retrieved titles to include only eligible articles. In the last stage, the PI and another reviewer shall read through the full articles for eligibility. At every stage, any differences in the outputs will be resolved through a discussion and if needed a decision will be derived by inviting athird screener. The Preferred Reporting Items for Systematic Reviews andMeta-Analyses (PRISMA) guidelines [27] will be used to report the screening process. (See Fig 1).
Charting the data
A data extraction form will be used that includes the following variables: author(s) and date of publication, country of publication, aims or purpose of the study, study design, key findings, and conclusion or recommendations. The charting form will be pre-testedby the reviewers on five to ten randomly selected studies to determine consistency[28]. This will be done by ensuring that the reviewers independently conduct a trial data extraction and later discuss as a team to ensure that the approach is in line with the objective. To improve the applicability, consistency,and quality of the chart, a continued review through an iterative process, which involves reading and re-reading the summaries, will be ensured. This process will entail continuous editing of the extraction formthroughout the duration of the study.
Collating, summarising, and reporting the results
All studies that meet the inclusion criteria will be analysed using both descriptive quantitative summaries(including figures) and qualitative thematic content analysis. Data relating to the beliefs and values of mothers or women and their social networks, in regards to childbirth by skilled health care providers in Africa,will be coded using NVivo version 12 (ref?). Emerging themes will be identified, coded, and categorised into major themes. The resulting themes will then be synthesised, summarised, and discussed in relation to the objective of the study and its implications onethicalpractice, policy, and future research.
Quality appraisal
To determine the methodological quality of the studies to be included, we will use the mixed method appraisal tool (MMAT) version 2018 [29]. The MMAT tool will help us determine the quality of the studies by examining the aptness of the aim of the study and the adequacy of the methodology, study design, participant recruitment, data collection, data analysis, presentation of findings, and authors’ discussions and conclusions. A scoring matrix in the MMAT tool will be used to independently appraise the quality of the studies,and the results from the scoring will be used to determine the overall quality of the article.