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Table 6 CERQual assessments of relevance in the context of a review finding––examples of serious concerns

From: Applying GRADE-CERQual to qualitative evidence synthesis findings–paper 6: how to assess relevance of the data

Review question: what are the experiences of African women regarding medically assisted birth in public hospitals in African countries?a
Finding 1: women feel that they are forced into having a medically assisted birth by medical staff in hospital settings
Dimensions of context to consider as specified in the question and protocol Assessment of relevance of each study contributing to the finding mapped against the review question context
Direct
relevance
Indirect relevance Partial relevance Uncertain relevance
Time: 2000––present Study 1
Study 2
  Study 3
Study 4
Study 5
Study 6
Place (country): African countries Study 1
Study 2
Study 3
Study 4
Study 5
Study 6
   
Phenomenon of interest: African women’s experiences of medically assisted birth in public hospitals in African countries    Study 1
Study 2
Study 3
Study 4
Study 5
Study 6
 
Health system: publicly funded health services Study 2 Study 1
Study 5
Health system private
Study 3
Study 6
Health system includes public/private mix
Study 4
Health system unclear
Population/perspective: African women’s perspectives African women’s perspectives    Study 1
Participants include non-African women giving birth in African countries
 
Population/perspective: African women’s perspectives Professional perspectives of women’s experiences   Study 2
Study 3
Study 4
Study 5
  
Population/perspective: African women’s perspectives Fathers’ perspectives of women’s experiences   Study 6   
CERQual assessment of relevanceb Serious concerns about relevance because the health systems within which women were treated in the contributing studies varied from the context of the synthesis question. In four studies the timeframe overlapped or was different. Five studies reported other actors’ interpretations of women’s experiences. Only one small study included the perspectives of women and some of the women’s views contributed to the synthesis were not African but they experienced the same issues giving birth in hospitals in African countries as African women.
  1. aHypothetical example generated from Bohren et al. [10]
  2. bAlso see paper 2 in this series on making an overall CERQual assessment [6]