Mapping of person-centred sexual and reproductive health interventions at primary healthcare settings: An umbrella review

ABSTRACT Introduction Sexual and reproductive health (SRH) is an essential component of primary healthcare (PHC). Advancing person-centred SRH promotes gender equality and ensures women and girls access high-quality care that respects their autonomy. This umbrella review synthesises key findings on existing person-centred SRH interventions in primary care settings, globally. Methods Searches were conducted in five bibliometric databases from 2016-2024. Reviews were included if they referred to person-centred SRH interventions, aimed at enhancing women’s autonomy, in PHCs. Two researchers independently screened reviews for inclusion, extracted and appraised quality of eligible reviews. Data was synthesised to identify themes and related person-centeredness. Results Of 1,300 identified reviews, 21 were included (twelve scoping, seven systematic, one integrative, and one narrative review). Geographic scope varied where eight were global, six focused on low- and middle-Income countries, and seven on high-income countries. These reviews explored multiple SRH topics (e.g., family planning, STIs/HIV, breast/cervical cancer). Four reviews explicitly referred to person-centredness; otherwise, person-centeredness was inferred. Synthesis identified five themes:1-Interactive decision- and counselling-support tools;2-Provider-initiated clinical prompts/support; 3-Remote/digital information channels;4-Integrated service delivery and accessibility strategies; and 5-Social/peer-led navigation. These interventions mainly addressed person-centred care domains of autonomy, dignity and communication, while trust, social support, and facility environment were addressed less. Conclusions Person-centred SRH interventions in PHCs have varied delivery modes highlighting innovation and a shift towards SRH care that is more responsive, accessible and respectful. Nevertheless, given limited explicit evaluation of person-centredness, future interventions need to encompass person-centred components to achieve holistic, person-centred SRH care for women and girls. SUMMARY BOX - Key Messages What is already known about the topic There are numerous existing systematic and scoping reviews on Sexual and Reproductive Health (SRH) interventions tackling specific SRH services. Despite this growing body of evidence and many reviews on SRH services and interventions, the existing literature is fragmented and often fails to address person-centeredness of these services and interventions. To our knowledge, no previous umbrella review has synthesised the available evidence and specifically addressed the concept of person-centred SRH care within primary healthcare settings. What this study adds This umbrella review provides a comprehensive overview of person-centred SRH interventions by synthesising high-level findings from 21 eligible reviews. By collating a global collection of systematic and scoping reviews on various SRH topics, this study highlights the available SRH interventions, describing their person-centredness, a concept that is not widely emphasised in the existing literature. It presents a high-level narrative synthesis, offering a comprehensive overview of the available person-centred SRH interventions in primary care settings that have the potential to enhance girls’ and women’s autonomy. How this study might affect research, practice and policy This umbrella review underscores the limited emphasis on person-centred SRH interventions, and the need to design more holistic, tailored interventions that consider the multiple domains of person-centred care to ensure women receive respectful SRH services that ensure autonomy, choice and supportive care. The synthesis of results highlights the need for standardised measurements of clinical and person-centred care outcome indicators.