The objectives of this scoping review are to:
- Map the available evidence on contraceptive use, unmet need, switching, and discontinuation among WWDs in LMICs.
- Review current contraceptive care models and identify evidence gaps in contraceptive practice among WWDs in LMICs.
To allow for the identification and mapping of existing contraceptive dynamics findings among WWDs, a scoping review protocol design was used. The procedures specified by Arksey and O'Malley's scoping review methodology, as well as Levac et al’s and Peters et al’s scoping methodology enhancement recommendations [21-23], were followed in this scoping review. As a result, when conducting this scoping review, the following steps will be followed: (1) identifying research questions; (2) identifying relevant studies; (3) selecting studies; (4) charting data; (5) collating, summarizing, and reporting the results; and (6) consulting with relevant stakeholders.
Stage one: identifying the research question
The overall main research question is defined as follows: 'What is known about the contraceptive dynamics and models of contraceptive care among WWDs in LMICs?' after consultation with the research team. This question would allow us to review and capture the full scope of existing literature while also allowing for the addition or modification of guiding research topics through an iterative manner. The following secondary questions were identified to guide the scoping review's subsequent stages and to supplement the overarching research question above.
The following questions will be addressed:
(1) What forms of contraceptive dynamics on WWDs have been studied in LMICs thus far?
(2) Where were contraceptive dynamics studies conducted in LMICs?
(3) What kinds of disabilities have been studied in the past?
(4) Where did the research take place (institution-based or community-based)?
(5) What is the prevalence of WWDs in LMICs, as well as unmet needs, contraceptive discontinuation, and switching?
(6) What are the hurdles that WWDs have identified to obtaining contraceptive services?
(7) What were the limitations of the LMIC-based contraceptive dynamic studies?
Stage two: identifying relevant studies
Search strategy and information sources
Searching electronic databases of published literatures will be used to find research that are relevant to this study. The major database to be searched will be PubMed (MEDLINE). CINHAL, Cochrane databases, and Global Health will be searched for articles that are not indexed in PubMed. We will additionally explore a range of grey literature sources to ensure that other important information is gathered. We'll look through grey literature resources (including Google Scholar, Google, OpenGrey, and WorldCat) to find research, reports, and conference abstracts that are relevant to this review. In addition, we will manually search the reference lists of all relevant material. The results of the search will be downloaded into a citation manager and imported into an EndNote library for further inspection and duplication detection.
The search terms to be used for WWDs include disability/ties, impairment/s, “physical disability/ties”, “physically impaired”, “hearing impairment/s”, “hearing loss”, deaf, “visual impairment/s”, blind, “visual loss”, “intellectual disability/ties”, “sensory disability/ties”, women, “reproductive age group” ’15-49 years”, and low-and middle-income countries. The search terms used for contraceptive dynamics include, contraception/s or contraceptive/s, “contraceptive method/s”, or family planning/s, or modern, traditional, or dynamic/s or utilization or use or unmet need or un-met need or discontinuation or dis-continuation or switching, changing, women, “reproductive age group” and “low-and middle-income countries”. Terms will be search as keywords in the title and/or abstract and medical subject headings (MeSH) as appropriate.
We used different synonyms of LMICs and the World Bank Country and Lending Groups June 2020 fiscal year list of LMICs (https://blogs.worldbank.org/opendata/newcountry-classifications-income-level-2019-2020). Literature search will be conducted by experienced research team members. GAF and AAM are an expert and trainer of literature search and systematic reviews. GAB has completed a 5-day intensive training on literature searches and systematic reviews. Moreover, we will be using established methods to ensure quality of the literature search, screening and information charting.
Stage three: study selection
We will use two different degrees of screening:
(1) A review of the title and abstract, and (2) a review of the full text
Two scientists independently screen all returned citations for inclusion using a set of minimum inclusion criteria. The full-text review will contain articles that are deemed relevant by one or both reviewers. The two investigators will next analyze the full-text articles independently to see if they match the inclusion/exclusion criteria in the second step. Any discordant full-text publications will be re-evaluated, and any remaining issues concerning research eligibility will be resolved by discussion at the full-text review stage. At this point, a third reviewer may be called to help resolve any disagreements.
At the beginning, halfway, and end of the abstract review process, reviewers will meet to address any issues or uncertainties related to study selection, as well as to go back and revise the search approach as needed. The number of studies included and excluded will be documented throughout the evaluation process. Before screening and charting, a calibration exercise will be undertaken on 20 randomly selected articles to establish team agreement. The inter-rater reliability and internal validity of our study's selection technique will be assessed using a statistical measure. A criterion of 80 percent agreement between coders has been established as acceptable . The evaluation procedure will be thoroughly documented so that the study can be reproduced by others.
Criteria for studies on contraceptive dynamics to be included We'll look for research on contraceptive use, unmet need, discontinuation and switching, and barriers to accessing contraception services by WWDs in LMICs using broad inclusion criteria.
The following requirements must be met in order to be considered:
(1) Studies must look into, appraise, or report on the contraceptive dynamics of women with disabilities in the reproductive age group; (2) studies must be published in English. We will include prospective and retrospective cohort studies, case-control or nested case-control studies, and cross-sectional studies in the contraceptive dynamic review. In addition, a reference list of systematic reviews will be used to find additional research.
The following studies must have assessed the effectiveness and outcomes of contraception dynamic care or any existing model of contraception dynamic care in LMICs: (a) studies that recommended guiding principles or approaches for designing effective models of contraception dynamic care in LMICs; (b) studies that recommended guiding principles or approaches for designing effective models of contraception dynamic care in LMICs. Studies that describe concepts/principles or models of contraceptive dynamics care in LMICs will be considered. We will use randomized controlled trials, quasi-experimental studies, prospective and retrospective cohort studies, case-control or nested case-control studies, and cross-sectional studies to evaluate the model of contraception care. Studies that were not found in the primary search will be forwarded to systematic review reference lists.
Exclusion criteria: This scoping review will exclude research from high-income nations, study procedures, commentaries, editorials, and case reports. Although the previously indicated inclusion and exclusion criteria will remain tight, as the research team gains a better understanding of the subject matter through the entire examination of studies, we may iteratively specify more criteria. We will not perform a quality assessment of the papers to be evaluated because it is not a common requirement of scoping reviews [25, 26]. However, we will use the parts of the Peer Review of Electronic Search Strategies (PRESS EBC Elements)  to improve the accuracy and completeness of the evidence-based search.
Patient and public involvement
No patient involvement
Stage four: charting the data
The study team created a data collecting instrument to retrieve data from the included studies for both the contraceptive dynamic and the model of contraception care. The team built the data charting form together and decided on the variables and level of detail of the data to be extracted. The study team will pilot the tool prior to the start of the review to ensure that it appropriately captures the information. The data abstracted for the contraception dynamic review will comprise
- Demographic data,
- Key findings, and
- Study limitations are all covered.
Two independent reviewers will abstract data, and the abstracted data will be compared. Any inconsistencies will be handled to ensure that the reviewers are on the same page. The data mining process will incorporate descriptive analytical approaches that summarize and synthesize information in a transparent manner, according to Arksey and O'Malley's advice and Peters et al's guidance for scoping review. As part of this methodology, a draft charting form is created based on the Joanna Briggs Institute (JBI) scoping review manual  and Peter et al's scoping review guidance  to record characteristics of the included studies as well as critical information pertinent to the review topic. Author(s), year of publication, source origin/country of origin, aims/purpose, study population and type of disabilities, sample size, methodology, intervention type (if available), comparator, duration of the intervention (if applicable), outcomes (if applicable), key findings that relate to the review question, and limitations of the studies will be included in the extraction field. In the conduct and reporting of this scoping review, we will use EndNote to organize and code references .
Stage five: collating, summarizing and reporting the results
We will present stage five in three discrete parts, as recommended by Levac et al: assessing the data, reporting results, and applying meaning to the results . The data will be summarized and reported in a way that maps the breadth of extant literature in the field of contraceptive dynamic and its model of contraception care in low- and middle-income countries. We'll map the concepts that underpin contraceptive dynamic research, as well as the types and quality of evidence available in LMICs. Furthermore, the available evidence on contraception dynamics and care models in LMICs will be mapped and described in detail. We will narrate the implications of findings within the larger framework for research, policy, and practice in order to make this scoping review more usable.
Finally, we'll give an overview of the research field and where it's at right now, as well as the gaps that exist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist and explanation style will be used to describe the results of our review .
Over the course of three months, the review team plans to conduct preliminary searches and complete literature searches, screening, and data charting. The results will then be gathered, summarized, and reported.
Stage six: consulting with relevant stakeholders
Consultation, according to Arksey and O'Malley, enhances methodological rigor. Once the early findings from stage five have been produced, seeking stakeholders' opinions (policymakers, practitioners, and researchers in Ethiopia) and their thoughts on applying the results to the scoping study would be considered.