Abstract

BackgroundViolence during pregnancy is a global problem, associated with serious health risks for both the mother and baby. Evaluation of interventions targeted for reducing or controlling domestic violence (DV) is still in its infancy, and the majority of findings are primarily from high-income countries (HICs). Therefore, there is an urgent need for generating evidence of DV interventions among pregnant women in low- and middle-income countries (LMICs).MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be employed to structure the review. A comprehensive search will be carried out via electronic databases including MEDLINE, CINAHL, Scopus, Embase, Web of Science, PsycINFO, and The Cochrane library. Gray literature will also be scrutinized for potential articles. An optimal search strategy has been developed following consultations with subject-matter experts and librarians. This search strategy will be adapted to the different databases. Experimental studies evaluating DV interventions among pregnant women from LMICs will be included in the review. The review will only include literature written in English. Two reviewers will independently screen and assess studies for inclusion in the review. A third author will resolve any discrepancies between the reviewers. Risk of bias will be assessed based on the Cochrane risk of bias assessment tool, and overall quality of the evidence will be judged using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Findings will be presented with the narrative synthesis, and if applicable, they will be further quantified using random-effects meta-analysis. Effect size, risk ratio for dichotomous variables, and standardized mean differences for continuous variables will be calculated for each outcome using Review Manager 5.3.DiscussionSystematic reviews to evaluate the efficacy of interventions to address DV within the perinatal context have been limited. Hence, no one intervention has emerged as substantially effective towards addressing perinatal DV and associated health consequences. The evidence generated from this systematic review will inform researchers and policy makers about the effectiveness of existing DV interventions among pregnant women in LMICs and provide recommendations for future research in this area. This in turn will contribute towards violence prevention in LMICs.Systematic review registrationPROSPERO CRD42017073938

Highlights

  • Violence during pregnancy is a global problem, associated with serious health risks for both the mother and baby

  • This protocol states the plan for a systematic review and meta-analysis of effectiveness of domestic violence (DV) interventions among pregnant women in low- and middle-income countries (LMICs)

  • Previous reviews were unable to provide a firm conclusion that a specific intervention was effective for addressing DV during pregnancy

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Summary

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) recommendations [45] have been used for preparing and reporting this systematic review protocol (see Additional file 1). Data extraction Study findings will be extracted on a structured database, developed in consultation with the research team It includes pertinent information such as study setting, study population, sample size, study population’s demographics, baseline measurements, details related to intervention and control conditions, theories used, study methodology, response rates, follow-up, outcomes, times of measurement, and assessment of risk of bias (see Additional file 3). Measurement of intervention effects For RCTs, NRCTs, and CBA studies, dichotomous outcomes will be presented as risk ratio (RR), and if adjusted analyses reported dichotomous outcomes (adjusting for potential confounders) in terms of odds ratio (OR), Review Manager (RevMan) 5.3 will be used to convert ORs to RRs [49]. Summary of the findings will be presented in a table, including pre-specified outcomes, effect measures, number of studies and participants, and grade of overall quality of the evidence

Discussion
Background
Findings
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