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

IntroductionPerson-centred care is crucial for quality, comprehensive healthcare, particularly in Sexual and Reproductive Health (SRH). This umbrella review synthesises key findings on existing person-centred SRH interventions in primary care settings, globally. MethodsSearches were conducted in five bibliometric databases from 2016 to 2024. Reviews were included if they referred to person-centred SRH interventions adopted in primary care settings. Two researchers independently screened reviews for inclusion and extracted and appraised quality of eligible reviews. Data was summarized to explore key themes, interventions and outcomes. ResultsOf 1,300 identified reviews, 21 were included (twelve scoping reviews, seven systematic reviews, one integrative review, and 1 narrative review). Geographic scope of the reviews was varied where eight were global in scope, six focused on low- and middle-Income countries, and seven on high-income countries. These reviews explored a variety of SRH topics (e.g. family planning counselling and uptake, sexuality and HIV or cervical cancer screening), across diverse contexts. Four reviews implicitly referred to person-centredness, otherwise person-centeredness of interventions was inferred. Person-centred counselling, technology-based interventions, strategies that improved primary healthcare services through electronic medical record enhancements or screening tools, and specific interventions for STI/HIV and breast/cervical cancer screening and risky behaviours demonstrated effectiveness in improving SRH services. Specific intervention components that were present in effective interventions included tailored communication, investment in informed choices, and addressing access barriers. Synthesis showed that interventions do not consider all domains of person-centred care. DiscussionOur results have shown that multicomponent interventions are effective. Combining accessible information (often technology-based) and tailored person-centred counselling are likely to be most effective in improving a range of SRH outcomes. Given the limited explicit evaluation of person-centredness and the incomplete capture of its domains within interventions, future interventions need to encompass more person-centred components to provide further evidence on pathways to enhance SRH care quality. Key MessagesO_ST_ABSWhat is already known about the topicC_ST_ABSThere are numerous existing systematic and scoping reviews on Sexual and Reproductive Health (SRH) interventions tackle 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 service 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 addsThis umbrella review provides a unique and comprehensive overview of potentially effective 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 empathised in the existing literature. It presents a high-level narrative synthesis, offering a comprehensive overview of the available and most potentially effective person-centred SRH interventions in primary care settings. How this study might affect research, practice and policyThis 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. There is limited evidence on rigorous evaluation of intervention effectiveness, especially across marginalized populations and in low- and middle-income countries. The synthesis of results highlights the need for standardized measurements of clinical and person-centred care outcome indicators.