Conclusion This systematic scoping review shows that current understanding of risk selection encompasses three main dimensions. Risk selection is used at the level of health care organisation as a means to allocate resources, align women’s and children’s needs with healthcare services and balance access to, and availability of resources with the perceived likelihood of needs, while ensuring timeliness of care. At the practice level, risk selection refers to detecting and assessing risk and making decisions about delivery of care. Risk selection is also used as a tool to ensure safe care. We found that these three dimensions have three themes in common; across these dimensions, risk selection is viewed as both requiring and providing regulation, has a provider centred focus, and aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make cross-setting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women’s needs, and unnecessary medicalization. Supporting information S1 Table. PRISMA checklist. (DOCX) S2 Table. Search strategies. (DOCX) S3 Table. Overarching themes, main categories and sub categories. (DOCX) S4 Table. Charactristics of included references. (DOCX) S5 Table. List of included references. (DOCX) Acknowledgments We thank Yvonne Smit and Michelle ten Berge for their support during the first phase of this study, and Henk Koffijberg, Michelle Willard and Gu¨lgen O¨ ztas, for helping with retrieving the full texts. Author Contributions Conceptualization: Bahareh Goodarzi, Pim Teunissen, Franc¸ois Schellevis, Ank de Jonge. Data curation: Bahareh Goodarzi. Formal analysis: Bahareh Goodarzi, Annika Walker, Lianne Holten, Pim Teunissen, Franc¸ois Schellevis, Ank de Jonge. Investigation: Bahareh Goodarzi. Methodology: Bahareh Goodarzi, Linda Schoonmade, Pim Teunissen, Franc¸ois Schellevis, Ank de Jonge. Project administration: Bahareh Goodarzi. Supervision: Ank de Jonge. ONE Risk selection in maternal and newborn care ONE | https://doi.org/10.1371/journal.pone.0234252 June 8, 2020 12 / 22 80 3 CHAPTER 3
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