Women’s reported experience of respectful maternity care measures worldwide: a systematic review

Abstract

BACKGROUND: Measuring women's experiences of Respectful Maternity Care (RMC) requires valid and reliable tools. Although several RMC tools exist, their methodological quality has not been thoroughly evaluated. AIM: To evaluate the quality of women's-reported experience of RMC measures worldwide. METHODS: A comprehensive search of PubMed, Scopus, Embase, Web of Science, and CINAHL databases was conducted. The study protocol was registered with PROSPERO (reference number CRD42024585853). The review followed the PRISMA guideline and employed the PICO framework. Peer-reviewed English-language studies published between 2014 and 2025 were included. The search targeted articles on Women Reported Experience Measures (WREMs) of RMC, with at least one psychometric property. Data were presented using Consensus-based Standards for the Selection of Health Measurement Instruments' (COSMIN) method. Tools were evaluated for methodological bias, item development, study quality, measurement properties, evidence synthesis, and certainty grading using the COSMIN. RESULTS: This review included 47 articles on the creation and psychometric assessment of 22 measures. Evidence indicating the scale development of each tool was inadequate. The risk of bias evaluation revealed inadequate methodological quality. Internal consistency and test-retest reliability were insufficient or not undertaken. Many measures were deemed inadequate in terms of criterion, cross-cultural, and structural validity. Responsiveness was reported in one tool and measurement errors were not reported in any tool. Currently, there is no level A recommended scale for measuring RMC. CONCLUSION: This review provided a comprehensive evaluation of the available tools to measure RMC. The quality of measurement properties of WREMs of RMC was inadequate. Future studies should develop and validate a standardised tool to measure women-reported experiences of RMC.