Perspectives of Mothers and Providers regarding Virtual Care Approaches during Pregnancy in High and Low-Income Countries: A Meta-Synthesis on Qualitative Studies

Background. Various conflicting views have been presented between beneficiaries from different countries regarding the usage of virtual prenatal care. This review aimed to explain the perspectives of mothers and providers in high- and low-income countries regarding virtual approaches during pregnancy. Methods. This synthesis was conducted with an aggregative technique (which adopts a pragmatist epistemological framework) by searching the Web of Science, PubMed, Scopus, ProQuest, SID, Irandoc, Magiran databases, and Google Scholar search engine from January 2005 to February 2021 and completed until December 2022. Qualitative and mixed-method studies in English were included in this review. Extracted codes were set in three areas: participants, type of views (+ or -), and countries' income levels. We used the JBI checklist for critical appraisal of the included studies. Results. Altogether, 1201 studies were retrieved, and finally, 16 articles were included in this review. We focused on the similarities of the extracted codes based on the stakeholders' perspectives. These codes were organized into seven categories: positive or negative belief/sense, socio-cultural issues, economic save or cost, communication and information, technical issues, access and utilization, and management issues. At both income levels countries, the availability of services, lack of trust in virtual methods, cost of services or smartphones, and challenging interactions were shared codes between mothers. Also, raising engagements and extending workloads were shared items between providers. Overall, language barriers, saving time, and Internet disconnection or poor connectivity were three shared codes between the beneficiaries at two levels of countries regarding virtual care during pregnancy. Conclusion. Paying attention to virtual methods in maternal care is inevitable. Evidence illustrated that mothers and healthcare providers had different positive or negative views on this issue. The stakeholders' perspectives should be considered in policies related to removing barriers and strengthening the benefits of virtual care during pregnancy.