This study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). This study protocol is being reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement 18 and checklist (Additional File 1).
Studies will be selected using the Population, Intervention, Comparator, Outcome and Study design (PICOS framework) 18 .
Participants: Only studies that are focused on adolescent parturients as a main study population or sub-analyses population of interest will be included. Adolescent parturient refers to anyone between 10 and 19 years old who has delivered within the past 6 months.
Interventions: Any interventions aimed towards providing RMC for adolescents will be included. Studies that are not aimed at RMC and /or are not targeted at adolescent parturients will be excluded
Comparators: Comparators in this study will include adolescents that receive routine or standard maternal care which is not specifically targeted at reducing intrapartum mistreatment.
Outcome: The primary outcome of interest is the incidence of RMC. Secondary outcomes include reported satisfaction with care and maternal and neonatal physical and psychosocial health.
Study design: Studies eligible for inclusion include cross-sectional studies, randomised control trials, quasi-experimental studies and cohort studies. To investigate the barriers and facilitators of respectful maternity care interventions, relevant qualitative studies will also be included. Only studies published in English and between January 1, 1990 and April 30, 2020 will be included.
Information Sources & Search strategy
The sources of information will be electronic databases including MEDLINE, PubMed, ScienceDirect, Cochrane, CINAHL, PsycINFO, Scopus, Google Scholar, and Web of Science. A search strategy using medical subject headings (MeSH) on the terms “Intrapartum Mistreatment”, “Disrespect and Abuse”, “Respectful Maternity Care”, “Adolescents”, “Teenager”, “Pregnancy” and “Compassionate care” together with BOOLEAN operators (“AND” / “OR”) will be used. The searches will be conducted by HH.
Data Extraction and Management
All identified studies will be saved into the online-based Mendeley reference manager. This manager has been selected for this study as it allows orderly download and storage of the selected abstracts as well as any available full-text versions. It also allows shared access by all the reviewers. The relevant titles and abstracts will be independently screened by two reviewers HH and JM. Articles meeting the selection criteria will be retained for independent assessment against the selection criteria by HH and JM. A data extraction tool in Ms-Excel will be used to assess and extract the pertinent preliminary information from the available abstracts. Components of the tool will be used to extract the relevant data which include author (s) names, year of publication, study design and/or methodology, study population, intervention(s), study setting, geographic location and results. The final list of articles will be downloaded in full text for detailed review. A PRISMA flowchart (Additional File 2) will be used to demonstrate the process of screening and identification of articles to include in the systematic review, with reasons for exclusion noted. Any discrepancies that arise will be reassessed and resolved by the full team.
Reporting quality in individual studies
Studies will be individually assessed for quality using the relevant Joanna Briggs Institute critical appraisal tool. Quality indicators that will be assessed will include randomisation, allocation, blinding, identical treatment, and the analyses method used in the studies. Using the criteria from these tools, a quality assessment of low, medium or high will be made. The two authors will review the methodological robustness of the studies against the eligibility criteria and the checklist independently. Discrepancies will be resolved by discussion, with the involvement of a third reviewer when there is a disagreement.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 18 will be followed during the review. A combination of narrative and thematic synthesis is proposed as most suitable for achieving this review’s objectives which aim to describe the existing literature as well as identify the strategies, outcomes, gaps and challenges in previous interventions. The narration will firstly summarise the methods, results and conclusions of the studies in prose. Subsequently, the running themes in the studies will be identified and grouped. The most prominent and recurrent themes will then be identified and analysed. The characteristics and themes will also be summarised in a tabular form in addition to the prose narratives. A quantitative analysis will be conducted if studies report prevalence of respectful maternity care before or after an intervention.