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      Family planning for urban slums in low- and middle-income countries: a scoping review of interventions/service delivery models and their impact

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          Abstract

          Background

          Although evidence suggest that many slum dwellers in low- and middle-income countries have the most difficulty accessing family planning (FP) services, there are limited workable interventions/models for reaching slum communities with FP services. This review aimed to identify existing interventions and service delivery models for providing FP services in slums, and as well examine potential impact of such interventions and service delivery models in low- and middle-income settings.

          Methods

          We searched and retrieved relevant published studies on the topic from 2000 to 2020 from e-journals, health sources and six electronic databases (MEDLINE, Global Health, EMBASE, CINAHL, PsycINFO and Web of Science). Grey and relevant unpublished literature (e.g., technical reports) were also included. For inclusion, studies should have been published in a low- and middle-income country between 2000 and 2020. All study designs were included. Review articles, protocols or opinion pieces were excluded. Search results were screened for eligible articles and reports using a pre-defined criterion. Descriptive statistics and narrative syntheses were produced to summarize and report findings.

          Results

          The search of the e-journals, health sources and six electronic databases including grey literature and other unpublished materials produced 1,260 results. Following screening for title relevance, abstract and full text, nine eligible studies/reports remained. Six different types of FP service delivery models were identified: voucher schemes; married adolescent girls’ club interventions; Willows home-based counselling and referral programme; static clinic and satellite clinics; franchised family planning clinics; and urban reproductive health initiatives. The urban reproductive health initiatives were the most dominant FP service delivery model targeting urban slums. As regards the impact of the service delivery models identified, the review showed that the identified interventions led to improved targeting of poor urban populations, improved efficiency in delivery of family planning service, high uptake or utilization of services, and improved quality of family planning services.

          Conclusions

          This review provides important insights into existing family planning service delivery models and their potential impact in improving access to FP services in poor urban slums. Further studies exploring the quality of care and associated sexual and reproductive health outcomes as a result of the uptake of these service delivery models are essential. Given that the studies were reported from only 9 countries, further studies are needed to advance knowledge on this topic in other low-middle income countries where slum populations continue to rise.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12939-021-01518-y.

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          Most cited references36

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          Scoping studies: towards a methodological framework

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            A typology of reviews: an analysis of 14 review types and associated methodologies.

            The expansion of evidence-based practice across sectors has lead to an increasing variety of review types. However, the diversity of terminology used means that the full potential of these review types may be lost amongst a confusion of indistinct and misapplied terms. The objective of this study is to provide descriptive insight into the most common types of reviews, with illustrative examples from health and health information domains. Following scoping searches, an examination was made of the vocabulary associated with the literature of review and synthesis (literary warrant). A simple analytical framework -- Search, AppraisaL, Synthesis and Analysis (SALSA) -- was used to examine the main review types. Fourteen review types and associated methodologies were analysed against the SALSA framework, illustrating the inputs and processes of each review type. A description of the key characteristics is given, together with perceived strengths and weaknesses. A limited number of review types are currently utilized within the health information domain. Few review types possess prescribed and explicit methodologies and many fall short of being mutually exclusive. Notwithstanding such limitations, this typology provides a valuable reference point for those commissioning, conducting, supporting or interpreting reviews, both within health information and the wider health care domain.
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              Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field.

              Policy-makers and managers have always used a wide range of sources of evidence in making decisions about policy and the organization of services. However, they are under increasing pressure to adopt a more systematic approach to the utilization of the complex evidence base. Decision-makers must address complicated questions about the nature and significance of the problem to be addressed; the nature of proposed interventions; their differential impact; cost-effectiveness; acceptability and so on. This means that Cochrane-style reviews alone are not sufficient. Rather, they require access to syntheses of high-quality evidence that include research and non-research sources, and both qualitative and quantitative research findings. There is no single, agreed framework for synthesizing such diverse forms of evidence and many of the approaches potentially applicable to such an endeavour were devised for either qualitative or quantitative synthesis and/or for analysing primary data. This paper describes the key stages in reviewing and synthesizing qualitative and quantitative evidence for decision-making and looks at various strategies that could offer a way forward. We identify four basic approaches: narrative (including traditional 'literature reviews' and more methodologically explicit approaches such as 'thematic analysis', 'narrative synthesis', 'realist synthesis' and 'meta-narrative mapping'), qualitative (which convert all available evidence into qualitative form using techniques such as 'meta-ethnography' and 'qualitative cross-case analysis'), quantitative (which convert all evidence into quantitative form using techniques such as 'quantitative case survey' or 'content analysis') and Bayesian meta-analysis and decision analysis (which can convert qualitative evidence such as preferences about different outcomes into quantitative form or 'weights' to use in quantitative synthesis). The choice of approach will be contingent on the aim of the review and nature of the available evidence, and often more than one approach will be required.
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                Author and article information

                Contributors
                jganle@ug.edu.gh
                baatiemaleonard@gmail.com
                payamahp@gmail.com
                oforicharlotte1@gmail.com
                edmeyaw19@gmail.com
                abdul-aziz.seidu@stu.ucc.edu.gh
                aankomah@popcouncil.org
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                19 August 2021
                19 August 2021
                2021
                : 20
                : 186
                Affiliations
                [1 ]GRID grid.8652.9, ISNI 0000 0004 1937 1485, Department of Population, Family and Reproductive Health, School of Public Health, , University of Ghana, ; P. O. Box LG 13 Legon, Accra, Ghana
                [2 ]GRID grid.8652.9, ISNI 0000 0004 1937 1485, Department of Health Policy, Planning and Management, School of Public Health, , University of Ghana, ; Accra, Ghana
                [3 ]AIDS Commission, Accra, Ghana
                [4 ]GRID grid.8652.9, ISNI 0000 0004 1937 1485, Regional Institute for Population Studies, , University of Ghana, ; Legon, Accra, Ghana
                [5 ]GRID grid.117476.2, ISNI 0000 0004 1936 7611, School of Public Health, Faculty of Health, , University of Technology Sydney, ; NSW Sydney, Australia
                [6 ]GRID grid.413081.f, ISNI 0000 0001 2322 8567, Department of Population and Health, , University of Cape Coast, ; Cape Coast, Ghana
                [7 ]GRID grid.1011.1, ISNI 0000 0004 0474 1797, College of Public Health, Medical and Veterinary Sciences, , James Cook University, ; Townsville, Queensland Australia
                [8 ]Population Council, Accra, Ghana
                Article
                1518
                10.1186/s12939-021-01518-y
                8375135
                34412647
                747f6b5c-1e70-45f4-9b88-8320c0078c1c
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 7 January 2021
                : 20 July 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000865, Bill and Melinda Gates Foundation;
                Award ID: OPP1179495
                Categories
                Systematic Review
                Custom metadata
                © The Author(s) 2021

                Health & Social care
                family planning,contraception,reproductive health,service delivery,urban slums,scoping review

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