Vulnerability in maternal, new-born, and child health in low- and middle-income countries: Findings from a scoping review

Objectives: To identify and synthesise prevailing definitions and indices of vulnerability in maternal, new-born and child health (MNCH) research and health programs in low- and middle-income countries. Design and setting: Scoping review using Arksey and O’Malley’s framework and a Delphi survey for consensus building. Participants: Mothers, new-borns, and children living in low- and middle-income countries were selected as participants. Outcomes: Vulnerability as defined by the authors was deduced from the studies. Results: A total of 61 studies were included in this scoping review. Of this, 22 were publications on vulnerability in the context of maternal health and 40 were on new-born and child health. Definitions used in included studies can be broadly categorised into three domains: biological, socioeconomic, and environmental. Eleven studies defined vulnerability in the context of maternal health, five reported on the scales used to measure vulnerability in maternal health and only one study used a validated scale. Of the 40 included studies on vulnerability in child health, 19 defined vulnerability in the context of new-born and/or child health, 15 reported on the scales used to measure vulnerability in child health and nine reported on childhood vulnerability indices. As it was difficult to synthesise the definitions, their keywords were extracted to generate new candidate definitions for vulnerability in MNCH. Conclusion: Included studies paid greater attention to new-born/ child vulnerability than maternal vulnerability, with authors defining the terms differently. A definition which helps in improving the description of vulnerability in MNCH across various programs and researchers was arrived at. This will further help in streamlining research and interventions which can influence the design of high impact MNCH programs. Scoping review registration: The protocol for this review was registered in the open science framework at the registered address (https://osf.io/jt6nr).