Leveling up evidence syntheses: filling conceptual gaps of the role of midwifery in health systems through a network analysis

Abstract

Objective: In the research note, our main objective is to explore the value of combining an evidence synthesis with a network analysis. The discussion is based on a critical interpretive synthesis, which combines systematic review methodology with qualitive inquiry, and 'research concept' network analysis focused on understanding the roles of midwives in health systems. The interpretative analytic approach of a critical interpretive synthesis has a high explanatory value by allowing for the review of a diverse body of literature and is well-suited to delving into areas that are not well understood, such as midwifery.

Results: Network analyses use graphs to represent relationships between concepts and brought to light important additional insights into the literature that were not present in the evidence synthesis alone. Given the lack of theoretical development in the area of midwifery in health systems, the critical interpretive synthesis allowed for the generation of concepts used to inform a theoretical framework, while the novel application of an exploratory network analysis deepened understanding of conceptual areas of saturation within the field, as well as identifying critical gaps in the literature.

Keywords: Critical interpretive synthesis; Evidence synthesis; Health policy; Health systems; Midwifery; Mixed methods; Network analysis; Sexual and reproductive health and rights.

Fig. 1

Network analysis of governance arrangements found in the literature on the roles of midwives in health systems

Fig. 2

Network analysis of financial arrangements found in the literature on the roles of midwives in health systems

Fig. 3

Network analysis of delivery arrangements found in the literature on the roles of midwives in health systems

Fig. 4

Network analysis of implementation strategies found in the literature on the roles of midwives in health systems