Exploring the Effectiveness and Engagement of Local Communities in Maternity Care Models for Women with Refugee and Migrant Backgrounds and Its Impact on Enhancing Perinatal Health Outcomes: A Comprehensive Systematic Review

OBJECTIVES: This systematic review aimed to synthesise evidence on the effectiveness and community involvement in maternity care models among refugee background women living in high-income countries.

METHODS: A comprehensive search of major databases for studies published in English between 2000 to 2022 was developed to identify literature using defined keywords and inclusion criteria. Two authors independently screened the search findings and the full texts of eligible studies. The quality of the included studies was appraised, and qualitative and quantitative results were synthesised narratively and presented in tabular form. The review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS: 165,834 women were included in the review from six countries. The review highlighted the positive impact of community and stakeholders' involvement in the implementation of models of maternity care. The review summarised the models of care in terms of their effectiveness in improving perinatal health outcomes and minimising medical interventions, continuum of care in maternity services, enhancing health literacy, maternity service use and navigating the healthcare system, social support, and sense of belongingness, and addressing cultural and linguistic barriers.

CONCLUSIONS: While the reviewed models demonstrated the effectiveness of community and stakeholder involvement in improving perinatal health outcomes, there was considerable variation in outcome measures and assessment tools across the models. Thus, reaching a consensus on prioritised perinatal outcomes and measurement tools is crucial. Furthermore, future research should focus on evaluating the cost-effectiveness of maternity care models for refugee women of refugee backgrounds to inform healthcare providers and policymakers about resource allocation decisions.