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Table 2 Example of using qualitative evidence to populate the evidence-to-decision framework criterion on how people value the outcomes

From: Qualitative Evidence Synthesis (QES) for Guidelines: Paper 2 – Using qualitative evidence synthesis findings to inform evidence-to-decision frameworks and recommendations

Guideline and framework

Source of the findings

Qualitative evidence synthesis findings

Text developed from these finding/s for the values criterion of the framework/s

Antenatal care (ANC) guideline – nutritional intervention frameworks [11]

Commissioned synthesis [35]

Synthesis Finding 10 – Brief and cursory encounters with healthcare providers during ANC appointments were highlighted by a number of women in a variety of contexts. The impersonal nature of the ANC encounter, coupled with a reliance on tests and procedures rather than conversation, left women feeling isolated and disenfranchised

Synthesis Finding 11 – Women’s willingness to engage with ANC was enhanced when healthcare providers were perceived to be authentic and kind. A friendly, respectful and attentive approach was appreciated by women, especially those who were feeling worried or anxious about their pregnancy

Synthesis Finding 23 – In many countries, women visit ANC providers to acquire knowledge and information about their pregnancy and birth. In situations where this is provided in a useful, appropriate and culturally sensitive manner, sometimes through the use of pictures and stories, it can generate a sense of empowerment and acts as a facilitator to further engagement. In situations where this approach is not adopted, e.g. where tests are not explained properly or information is infused with medical jargon or is outdated and irrelevant, it acts as a barrier and limits further access

A scoping review of what women want from ANC informed the outcomes for the ANC guideline. Evidence showed that women from various resource settings valued having a positive pregnancy experience comprising three equally important components, namely effective clinical practices (interventions and tests, including nutritional supplements), relevant and timely information (including dietary and nutritional advice), and psychosocial and emotional support, provided by knowledgeable, supportive and respectful healthcare practitioners to optimise maternal and newborn health (high confidence in the evidence)