A scoping review of person-centred maternity care service in humanitarian and fragile settings.

Introduction: Women who live in humanitarian settings are three times more likely to die than those who live in peaceful environments. Person-centred maternity care (PCMC) is a fundamental human right for every woman, yet it is often overlooked in humanitarian contexts. This scoping review aims to summarise person-centred maternity healthcare in fragile and humanitarian contexts.

Methods: A scoping review of quantitative and/or qualitative approach was conducted to assess person-centred maternity care in humanitarian settings. Research that assessed dimensions of PCMC such as autonomy, dignity, privacy, communication, confidentiality and supportive care was included. Electronic database searches of PubMed, MEDLINE, EMBASE, PsycINFO, Scopus and generic web searches (Google Scholar) were used to search for available evidence. We used the Preferred Reporting Items for Systematic Review and Meta-Analyses criteria for scoping review statement. The data from the final selected articles were extracted into an Excel spreadsheet. Finally, we described the study characteristics and summarised the concept of person-centred care.

Result: A total of 889 articles were identified. After exclusion by title and abstract, 71 articles were eligible for full-text review, and finally 16 articles were eligible for data extraction. Our findings revealed low respect and supportive care, poor communication and autonomy, and breach of privacy. Resource constraints, protracted insecurity, cultural and language barriers were attributed to poor person-centred sexual and reproductive health. The review identified several implemented interventions, including training for healthcare providers, access to language translators, social and cultural support programmes, free healthcare services and community engagement initiatives.

Conclusion: There are significantly more reports of negative experiences of maternity healthcare services than positive ones. Prioritising culturally appropriate approach, simulation-based training for healthcare providers on person-centred care, community engagement and the integration of PCMC domains into existing health services are essential to improve quality maternal health.