Facilitated group care for maternal and child health model fidelity: A scoping review.

Abstract

Group care is a transformative model of prenatal, postnatal, and well-child care. The Centering-based group care model has three core components: health care, interactive learning, and community building. It has been implemented in 33 countries with associated improved maternal and child health outcomes. Maintaining fidelity to the model is essential for its effectiveness. However, to date no standardised measure of fidelity to the group care model exists. This review aimed to explore how fidelity is measured in group care and identify common themes to understand what is essential to maintain fidelity. We used the scoping review framework by Arksey & O'Malley, which included a consultation of experts and the Conceptual Framework for Implementation Fidelity to organise themes across group care fidelity measurement tools. Twenty-four articles were included spanning 12 countries in Africa, Asia, Europe, and North America. Common themes were: 1) adherence to the three core components; 2) exposure is not well understood; 3) quality of delivery is interconnected with facilitators' training; 4) participant responsiveness is focused on group dynamics; and 5) programme differentiation focused on type of facilitators. This review lays the foundation for creating a standardised tool to measure fidelity to the group care model across settings.