Inclusion of women in the construction of quality of maternal care indexes: A systematic scoping review
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Maternal mortality rates remain alarmingly high in low- and middle-income countries (LMICs). A critical challenge is measuring the quality of maternal care. Composite indexes are widely used but often rely on objective indicators that overlook women’s lived experiences. Although participatory approaches are increasingly encouraged, it remains unclear how women’s perspectives can be integrated into existing measures. This review systematically examines the construction of composite indexes for maternal care quality in sub-Saharan Africa, focusing on studies incorporating women’s experiences. A scoping review was conducted. Four reviewers searched four databases (Medline, Embase, Global Health, CINHAL) using English keywords on February 14, 2024, with no publication date limitation. Results were organized using the Organization for Economic Co-operation and Development framework for index construction: theoretical framework selection, metric selection, and weighting. Of 5,347 initial records, 111 articles were included across 40 countries. The Donabedian framework was most cited (n=38), yet 52 studies did not mention a framework. Women’s involvement was largely limited to survey responses (n=102), with only eight studies engaging them in result interpretation and two in indicator selection. No studies involved women in index weighting. Despite calls for inclusive approaches, women’s perspectives remain underrepresented in measuring maternal care quality in sub-Saharan Africa.
Source: SSM - Health Systems
Institutions: Centre de recherche en santé publique, Université de Montréal
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,490
OpenAlex ID: W7204939271