Mapping of person-centred sexual and reproductive health interventions in primary healthcare settings: an umbrella review.

Abstract

Introduction: Sexual and reproductive health (SRH) is an essential component of primary healthcare (PHC). Advancing person-centred SRH promotes gender equality and ensures women and girls access high-quality care that respects their autonomy. This umbrella review synthesises key findings on existing person-centred SRH interventions in PHC settings, globally.

Methods: Searches were conducted in five bibliometric databases from 2016 to 2024. Reviews were included if they referred to person-centred SRH interventions, aimed at enhancing women's autonomy, in PHC settings. Two researchers independently screened reviews for inclusion, and extracted and appraised the quality of eligible reviews. Data were synthesised to identify themes and related person-centeredness.

Results: Of 1300 identified reviews, 21 were included (twelve scoping, seven systematic, one integrative and one narrative review). Geographic scope varied where eight were global, six focused on low- and middle-income countries, and seven on high-income countries. These reviews explored multiple SRH topics (eg, family planning, sexually transmitted infections/HIV, breast/cervical cancer). Four reviews explicitly referred to person-centredness; otherwise, person-centeredness was inferred. Synthesis identified five themes: (1) Interactive decision- and counselling-support tools, (2) Provider-initiated clinical prompts/support, (3) Remote/digital information channels, (4) Integrated service delivery and accessibility strategies and (5) Social/peer-led navigation. These interventions mainly addressed person-centred care domains of autonomy, dignity and communication, while trust, social support and facility environment were addressed less frequently.

Conclusions: Person-centred SRH interventions in PHC settings have varied delivery modes highlighting innovation and a shift towards SRH care that is more responsive, accessible and respectful. Nevertheless, given limited explicit evaluation of person-centredness, future interventions need to encompass person-centred components to achieve holistic, person-centred SRH care for women and girls.