Promising Programs, Policies and Practices that Support Pregnant People who Use Drugs’ Access to Sexual and Reproductive Health Care in Canada: A Scoping Review Protocol

Background: Evidence suggests the pregnant people who use drugs (PPWUD) encounter many barriers to reproductive and sexual health services, including stigma of substance use, limited availability of services and the need for service navigation support. Barriers to reproductive and sexual health services for this population is concerning given the health harms of substance use while pregnant for both parent and child; however, little is known about potential programs, policies and practices that may support access to these essential services. Aim: This scoping review will provide an overview of peer-reviewed and grey literature on existing policies, programs and practices that support pregnant people who use drugs' access to sexual and reproductive health care in Canada amidst an ongoing drug poisoning crisis. Methods: This scoping review will examine peer-reviewed and grey literature (e.g. websites of Canadian government agencies, harm reduction organizations etc.) published between 2016-2023 in English and French using a piloted search strategy. Literature that discusses, defines, conceptualizes or evaluates programs, policies and practices that support pregnant people who use drugs' access to sexual and reproductive health care will be included in our review. We are particularly interested in illicit drug use as defined by Health Canada. Two independent reviewers will screen titles/abstracts of peer-reviewed literature and one independent reviewer will screen titles/abstracts of grey literature. Two independent reviewers will screen full texts and references of included articles. All included articles will have relevant data extracted for analysis using a piloted data extraction tool. Results: We anticipate that results will highlight key programs, policies and practices that support PPUWUD's access to reproductive and sexual health services in Canada. Conclusion: This review will provide important insight into available programs, policies and practices that are supporting access to this key underserved population in Canada, particularly during the ongoing drug poisoning crisis that has taken the lives of over 35,000 Canadians. Findings may also identify key gaps in programs and practices, such as geographic inequity, that can inform future policy and program planning decisions.