The effectiveness of interventions to improve access to and utilization of prenatal care: a systematic review protocol.

Abstract

REVIEW QUESTION/OBJECTIVES: The quantitative objective is to identify the effectiveness of novel or innovative interventions designed to improve access to and utilization of prenatal care. More specifically, the objective is to identify: The effectiveness of novel or innovative interventions designed to improve access to and utilization of prenatal care on the timing of the initial prenatal care visit and the total number of prenatal care visits in pregnant women. INCLUSION CRITERIA Types of participants: This review will consider studies that include pregnant women. Types of intervention(s)/phenomena of interest: The review will consider studies that evaluate novel and innovative interventions designed to increase accessibility and utilization of prenatal care and comparing these programs against the regular existing programs. Studies evaluating group prenatal care and/or CenteringPregnancy© will be excluded from this review, because four systematic reviews have already examined the outcomes of these studies. The interventions of interest involve novel or innovative programs or specific interventions (e.g. incentives, enablers) intended to improve accessibility and utilization of prenatal care. Types of outcomes: This review will consider studies that include the following outcome measures: timing of initiation of prenatal care, number of prenatal care visits or use of a utilization index to measure adequacy of care. Definition A utilization index is defined as a measurement tool designed to categorize PNC utilization as being adequate or inadequate based on timing of initiation of care and number of visits with adjustments made for gestational age at delivery.