Objective: To identify the barriers and facilitators in the identification and management of high-risk pregnancies in India. Methods: A systematic search of PubMed and Google Scholar was conducted from the inception of database till 27 March 2024, using predefined keywords and search terms, including “high risk pregnancy,” “identification,” “management,” “barrier,” “challenge,” “facilitator,” “enabler,” and “India,” combined using Boolean operators (AND/OR). Only studies published in English were included. Screening was conducted using Rayyan software. Data were extracted into structured tables and synthesized using a qualitative thematic approach to identify key barriers and facilitators in the identification and management of high-risk pregnancies. Results: A total of 144 publications were identified. After screening based on eligibility criteria, 21 studies were finally included in the review. The included studies highlighted multiple barriers in the identification and management of high-risk pregnancies, including knowledge and awareness gaps among women and healthcare providers, inconsistent clinical management, and inadequate infrastructure. Financial constraints and cultural factors further added to the challenges. Women in tribal and rural areas faced additional barriers such as geographical isolation, lack of transportation, and limited access to specialized maternal healthcare. Facilitators identified in the literature included social support networks, the role of community health workers in bridging gaps between facilities and communities, and targeted education programs. Improved health literacy, standardized clinical protocols, and tailored management strategies were also reported as important facilitators. Conclusions: This review highlights the importance of strengthening healthcare infrastructure and addressing the identified barriers comprehensively to improve maternal and fetal outcomes. Enhancing awareness, empowering community health workers, and adopting standardized management protocols can contribute significantly to better identification and management of high-risk pregnancies in India.
Verma et al. (Fri,) studied this question.