Factors influencing the capacity of healthcare providers to deliver disability-inclusive maternity care services: A scoping review

Abstract

Objective

Current evidence highlights that women with disabilities experience challenges in accessing maternity care. Improving access requires an understanding of the factors influencing the capacity of healthcare providers to provide disability-inclusive care. Although providing maternity care services for women with disabilities has been reported to be a rewarding experience, numerous factors may impact health care providers’ capacity to do so. Limited evidence, especially from low and middle-income countries (LMICs), undermines our understanding of this issue and how to respond. This scoping review, therefore, aims to synthesise the current published literature examining factors influencing the capacity of healthcare providers to deliver disability-inclusive maternity care services.

Design

This scoping review used the Arksey and O'Malley framework in accordance with the PRISMA extension for Scoping Reviews. A systemic search of six electronic databases, including MEDLINE (Ovid), CINAHL Complete, Scopus, Eric Ebsco, Web of Science Core Collection, and EMBASE (Ovid), was undertaken to identify relevant studies. Snowball searching of reference lists and citations was also performed. The Quality of Care Framework for Maternal and Newborn Health, developed by the World Health Organization, was employed to guide the analysis and synthesis of the findings of this review.

Findings

Twenty-four studies published between 2000 and 2023 met the inclusion criteria. Factors influencing the capacity of healthcare providers to provide disability-inclusive maternity care were identified and categorised into six domains aligning with the Quality of Care framework: 1) Evidence-based practices for routine care and management of complications; 2) Actionable information systems; 3) Effective communication; 4) Respect and dignity; 5) Competent and motivated human resources; and 6) Essential physical resources available.

Key conclusions and implications for practice

This scoping review synthesised evidence on six key factors affecting the capacity of healthcare providers to provide disability-inclusive maternity care. It highlights the need to address the limited application of a ‘disability lens’ to evidence-based guidelines and health information. The review also highlights the need to better enable healthcare providers at all stages of their training and clinical practice to develop their knowledge and skills in providing respectful, disability-inclusive maternity care, in addition to ensuring essential physical resources are available. Very few studies examine the capacity of healthcare providers in low- and middle-income countries. Future research should focus on developing context-specific evidence from such countries, particularly given that this is where the majority of women with disabilities live.