Table 2 Summary of key findings

A1

Countries: Afrika Selatan, Uganda, Kenya, Tanzania, Zimbabwe, Malawi, Zambia, India, Brazil, Malaysia, Iran, and Bangladesh [5]

This study aims to delineate the objectives of strategies employed by low- and middle-income countries (LMICs) in creating palliative care services in rural areas.

The review approach entailed doing a thorough search in four electronic databases (Ovid MEDLINE, Ovid Emcare, Embase classic + Embase, and CINAHL), which led to the inclusion of 7 out of 30 publications. The assessed papers were determined to have a low methodological quality.

Healthcare providers and volunteers were given training and mentorship. Effective palliative care in rural regions of low- and middle-income nations relies on cooperation among healthcare practitioners, volunteers, religious authorities, and technology.

A2

Countries: Guatemala [6]

To evaluate the existing collaboration with traditional birth attendants who have access to mHealth technology to improve the detection of high-risk pregnancies and childbirth difficulties.

The study encompassed a population of 95,000 traditional birth attendants (TBA), with a subset of 41 TBAs being used as a sample. The data were analysed using statistical process control techniques.

During 12 months, traditional birth attendants (TBAs) assisted in 847 births, while referral rates increased from 14 to 27.5. The implementation of Obstetric Care Navigation (OCN) significantly improved the quality of treatment at the facility level, with an increase from 24–62%. The most frequent causes for referrals were hypertensive problems and protracted labour. OCN also offered emergency transportation and labour assistance, showcasing its efficacy as a practical and patient-focused improvement for maternity care.

A3

The countries that are the focus of this study include Madagascar, Somalia, Ethiopia, Chad, Niger, Sudan, Sierra Leone, Burundi, Uganda, Nigeria, Liberia, India, Kenya, Rwanda, Zambia, Tanzania, South Africa, Botswana, Morocco, Ghana, Uzbekistan, Vietnam, Indonesia, Pakistan, and Cambodia. Additionally, the research also encompasses countries such as Bangladesh, Nepal, Guinea, Mali, Mozambique, and Senegal [7].

The objective is to assess the impact and expenses and create novel simulations addressing the prospective outcomes for mothers, fetuses, and infants. This will be done by improving midwifery services, including family planning, in 58 countries with low and middle incomes.

The research identified precise interventions involving midwives or obstetricians, and the sample included 58 low- and middle-income nations.

While obstetricians are more effective in reducing maternal and fetal fatalities, expanding midwifery services can avoid a greater number of newborn deaths compared to exclusively focusing on obstetrics. Midwifery presents a financially efficient approach to reducing mortality rates by delivering comprehensive care from the home to the medical facility. In addition, midwives excel in providing breastfeeding counselling, resulting in more substantial decreases in infant mortality compared to obstetricians.

A4

Countries:

India, Ethiopia, Ghana, Uganda, Kenya, Nepal, Tanzania, Nigeria, Gambia, Malawi, Thailand, Liberia, Kamboja, Laos, dan Rwanda [8].

The purpose is to present an outline of the difficulties associated with human resources for health in guaranteeing high-quality care for newborns in countries with low and intermediate incomes.

A scoping thematic analysis was performed, utilising papers obtained through database searches and manual scrutiny of references and country reports. Thematic analysis was subsequently used to identify and classify ten distinct HRH issues.

There is a notable deficiency in healthcare professionals that possess expertise in neonatal care. Examining this problem provides valuable perspectives for formulating new WHO approaches to address these difficulties and enhance the workforce for neonatal care, ultimately resulting in improved outcomes for newborns.

A5

Country: Zambia [9]

The objective is to evaluate the effects of midwife training and infant care on decreasing neonatal and perinatal mortality rates in developing nations.

The design included a Train-the-Trainer model, which included a group of midwives and 71,689 neonates.

The perinatal mortality rates decreased, while the stillbirth rates remained constant. There was a considerable drop in the mortality rate of newborns within the first seven days after receiving training in the Neonatal Resuscitation Program. Providing training to midwives in Essential Newborn Care (ENC) resulted in a decrease in 7-day infant mortality in low-risk clinics. Further enhancing the death rates could be achieved by providing further foundational instruction in neonatal resuscitation.

A6

Country: Bangladesh [10]

To examine equity in utilising home-based versus facility-based obstetric services in rural Bangladesh through an observational study.

A multinomial logistic regression and a binomial log-link regression analysis were conducted.

This study examined the disparities between home-based and facility-based obstetric services in rural Bangladesh. Findings revealed that despite the expansion of facility-based care, home births attended by midwives remained predominant. The study emphasizes the need to evaluate the cost, feasibility, and effectiveness of these approaches to improve maternal health equity.”

A7

Countries: Zambia, India, Kenya [11]

To explore how, why, to what extent, and for whom Community Engagement (CE) influences both intended and unintended outcomes in Maternal and Newborn Health (MNH) programming, emphasising the communication aspects of CE.

The realist review methodology focused on a sample of CE interventions within Maternal and Newborn Health (MNH) programming.

A previous realist review on Community Engagement (CE) in health research highlighted the significance of fostering strong “working relationships” between communities and researchers. It also examined the key factors and processes influencing CE and its impact on the research process.

A8

Countries: Argentina, Kuba, Arab Saudi, Thailand, and Zimbabwe [12]

To compare the outcomes of antenatal care programs with reduced visits for low-risk women to those of standard care.

The trials conducted by the group involved a population of 60,000 women, with the sample consisting of pregnant and postpartum women.

Women expressed dissatisfaction with the fewer visits, feeling that the intervals were too extended. Although fewer visits might reduce costs, women in high-income countries typically had between 8.2 and 12 visits. In contrast, in low- and middle-income countries, many women had fewer than five visits, often with modifications to the content of each visit.

A9

Countries: Ghana, Uganda, Afrika Selatan, Indonesia, Afghanistan, Nepal, and India [13].

To create a comprehensive map of the literature on barriers to quality midwifery care using a systematic and replicable approach and validate the analytical framework developed during the Women Deliver session by thoroughly detailing the identified barriers and the reviewed literature types.

A systematic mapping was conducted, resulting in 9,126 items being retrieved across five databases and from a call for papers, which was narrowed down to 7,344 items. Data for analysis were extracted from all 82 selected items. The sample included midwives, maternity staff, nurse-midwives/nurses, obstetricians, paediatricians, physicians, and neonatal nurses.

The mapping findings reveal that quality midwifery care is impeded by socio-cultural, economic, and professional barriers, all of which are deeply rooted in gender inequality. The perception of midwifery as “women’s work” contributes to the “gender penalty,” positioning women at the lower end of occupational and economic hierarchies.

A10

Countries: Colombia [14]

To examine traditional birth attendants (TBAs) by exploring who they are, the number of births they attend globally, the locations where they provide delivery care, and their interactions with the formal healthcare system and the communities they serve.

A systematic mapping was conducted, focusing on a sample of pregnant women.

Although the role of Traditional Birth Attendants (TBAs) in healthcare is diminishing, they continue to be essential in rural areas where health services are limited. Despite efforts to enhance access to skilled healthcare providers in these regions, there remains a shortage of trained professionals and financial limitations.

A11

Countries: Kenya [15]

To create appropriate metrics for evaluating the quality of nursing care in low- and middle-income countries (LMICs) where such assessments are currently lacking.

Method: A literature review was conducted through a scoping review approach, utilising databases such as EMBASE, CINAHL, MEDLINE, and Google Scholar, with a sample of 52 studies focused on nursing care.

Kenya’s proposed Nursing Sensitive Indicators (NSIs) address a global need to monitor nursing care quality in low- and middle-income countries (LMICs). These indicators require validation and refinement to achieve standardisation, allowing LMICs to participate in or establish professional networks to enhance care quality.

A12

Countries: Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Zimbabwe, Bangladesh, and Pakistan [16]

To identify the most efficient and effective methods for low- and middle-income countries (LMICs) to conduct pre-service and in-service education and training, ensuring that care providers are adequately prepared to deliver quality maternal and newborn care.

A Rapid Systematic Evidence Review was performed, involving a systematic search across databases including Medline, CINAHL, LILACs, PsycINFO, ERIC, and MIDIRs. The study focused on a population of 19, with a sample comprising maternal and newborn care providers.

The studies demonstrated improved knowledge and skills but lacked evidence regarding their impact and theoretical foundation. Aligning these skills with the Quality Maternal and Newborn Care framework is crucial for enhancing midwifery care and contributing to advancing the Sustainable Development Goals.

A13

Countries: Guatemala [17]

To investigate the availability of various providers who deliver care during pregnancy and to examine the specific characteristics of midwives.

The method was qualitative, with a sample focusing on pregnancy and the postpartum period.

In Guatemala, although 75% of midwives have received formal training and are encouraged to make referrals, the majority of pregnant women still do not seek care from biomedical providers.

A14

Countries: India, Sudan [18]

To explore community healthcare systems in developing countries.

The method used was qualitative, focusing on children under 5.

The community health center aims to deliver two-thirds of essential healthcare services, including prenatal supervision, midwifery, neonatal care, treatment of endemic diseases, and emergency care for accidents. Initial findings suggest that practical experience and community recognition play a more significant role in a health practitioner’s effectiveness than formal education. Additionally, enhancing diet, hygiene, and sanitation is crucial for optimizing community health outcomes.

A15

Countries: Somaliland, Kenya, Malawi, Swaziland (now known as Eswatini), Zimbabwe, Tanzania, and Sierra Leone [19].

Exploring ways to enhance critical obstetric and neonatal care in countries with limited resources.

The qualitative method involves 600 healthcare providers, including nurse-midwives, doctors, clinical officers, and specialists.

The training led to a significant increase in knowledge and skills (p < 0.001) in pregnancy and newborn care. Participants expressed high satisfaction levels, and the program promoted evidence-based practices and improved teamwork.

A16

Countries: Nigeria [20]

To observe the rise in maternal mortality rates in developing countries.

Quantitative method with a sample of pregnant individuals.

Global health policies should prioritise support for developing countries, emphasising financial and technological assistance. While universal formal education is a crucial strategy, challenges persist in modernising these societies.

A17

Countries:

Nepal, India, Pakistan, Bangladesh, Tanzania, Uganda, Ethiopia, Senegal, Kenya, and Papua New Guinea [21]

To synthesise implementation lessons on birth kits, focusing on the context, user, usage requirements, and logistics of kit distribution.

A systematic literature review with a focus on maternal and child health. The review included 28 articles, which described a total of 21 birth kits used across 40 different countries.

The community health center aims to deliver two-thirds of essential healthcare services, including prenatal supervision, midwifery, neonatal care, treatment of endemic diseases, and emergency care for accidents. Initial findings suggest that practical experience and community recognition play a more significant role in a health practitioner’s effectiveness than formal education. Additionally, enhancing diet, hygiene, and sanitation is crucial for optimizing community health outcomes.

A18

Countries: Ghana [22]

To examine the coping strategies employed by Ghanaian midwives to manage and complete their work effectively.

This study utilised the Glaserian Grounded Theory. Data were gathered through non-participant observations and semi-structured interviews. The participants included 29 midwives working in labour/birthing environments, a pharmacist, a social worker, a National Health Insurance Scheme manager, and a health services manager.

The midwives’ motivation, driven by a deep commitment to safeguarding the lives of women and newborns and a strong passion for the midwifery profession, was identified as a key factor in overcoming workplace challenges. This dedication enabled them to adapt, take leadership in the birthing process and environment, and maintain engagement with professional and social networks, all of which contributed to their effectiveness in delivering quality care.

A19

Countries: Brazil [23]

Calculate the frequency of institutional delivery, SBA coverage, and the combination of delivery location and attendant type in low- and middle-income countries (LMICs). Similar assessments were recently released for 57 nations using DHS data, concentrating on the public and private sectors in four global areas.

Analyses Surveyed cross-sectional sample of 80 LMICs and women between the ages of 15 and 49 who are fertile

Comprehensive analyses that consider both the place of delivery and the type of birth attendant are essential for promoting safe childbirth, particularly in remote areas where skilled birth attendants are scarce. Home births attended by skilled birth attendants (SBAs) were more common among women in lower socioeconomic groups than in urban settings. Additionally, deliveries without the assistance of an SBA remain widespread in underserved and remote communities.

A20

Countries: Pakistan [24]

To gauge the Examination and evaluation of enhancements made to the high-quality healthcare systems in developing nations

We searched peer-reviewed databases MEDLINE, CINAHL, and PubMed for national and international literature.

Effective quality assessment methods can provide valuable guidance on optimizing resource allocation in developing countries, enabling healthcare systems to efficiently manage limited resources while addressing the needs of a growing population and improving healthcare services.

A21

Countries: Uganda [25]

Education aims to provide males with the necessary information and skills to support women throughout pregnancy and childbirth.

A scoping review was conducted using Bournemouth University’s iteration of the EBSCO Discovery Service (EDS) tool, identifying 33 studies. The findings highlight the rationale for involving men in maternity care.

Involving men in maternity care can significantly improve health outcomes for both mothers and infants. Through health education programs, men can acquire the knowledge and skills necessary to support women’s health during pregnancy, childbirth, and the postpartum period.

A22

Countries: Bangladesh, India, Kenya, Uganda, Zambia, Niger, Nepal, Cambodia, Senegal, Malawi, Papua N, Honduras, and Ukraine [3]

Examining cost-effective methods to boost the supply and use of maternity and newborn health care in low- and lower-middle-income nations

A systematic review was conducted using searches across six electronic bibliographic databases: Medline, Embase, Global Health, EconLit, Web of Science, and the NHS Economic Evaluation Database. The review included 48 publications focused on maternal and newborn health care.

It was determined that cost-saving measures could include establishing women’s support groups, utilizing community health workers and traditional birth attendants for newborn care at home, enhancing routine prenatal care services, implementing programs to ensure adherence to care standards, and promoting breastfeeding in maternity hospitals. However, comparing the cost-effectiveness of these various approaches proved challenging due to differences in metrics and evaluation methods.

A23

Countries: Nepal, India, Bangladesh, and Pakistan. [26]

To outline the elements influencing pregnant women’s care-seeking behaviour and investigate potential treatments that could increase the number of facility-based births among women in South Asia.

A literature review was conducted using various databases, including PubMed. Data sources from the World Health Organization (WHO), the United Nations Population Fund (UNFPA), and non-governmental organisations such as Safe Motherhood Nepal were also searched. The review included 100 articles.

A comprehensive approach is crucial to increasing the use of facility-based childbirth services among women in rural Nepal. This study highlights three key strategies that should be prioritized in South Asian countries to expand access to skilled birth attendants within healthcare institutions.

A24

Countries: Angola, Benin, Malawi, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Senegal, and Zambia [27]

To investigate the delivery of midwife-led care in low- and middle-income nations.

A scoping review, an organised search of Pubmed, EMBASE (Ovid), Web of Science, Scopus, Google Scholar, The Cochrane Library, and a manual search of pertinent international organisation websites, journals, and grey literature were carried out. 3483 pieces of content

There is limited data on the effectiveness of midwife-led care in low- and middle-income countries, where it is not widely practiced. However, most studies have examined its implementation across different healthcare settings. The structure of midwife-led care varies considerably, along with differences in education, regulation, and training standards. While midwife-led care is available in many low- and middle-income countries, its quality is often restricted by inadequate support systems and resources.

A25

Countries: Iran [28]

To provide an overview of the qualitative research on the obstacles to PNC management in LMICs related to the healthcare system.

A systematic review of the qualitative literature was conducted by searching databases such as PubMed, Web of Knowledge, CINHAL, SCOPUS, Embase, and Science Direct for qualitative studies performed in low- and middle-income countries (LMICs). The sample population included 1,677 participants, comprising 629 pregnant women, 122 mothers, 240 healthcare providers, 54 key informants, 164 women of childbearing age, 380 community members, and 88 participants from other groups (such as male partners or other key informants).

The research emphasizes that postnatal care (PNC) in LMICs has substantial obstacles related to staffing, provision of services, availability, and infrastructure. Research undertaken in multiple countries with a range of participants, including healthcare workers, pregnant women, male partners, and community members, has shown an understanding of postnatal care (PNC) across the healthcare system.

A26

Countries Africa, Asia, and Latin America [29]

To examine the views, experiences, and behaviours of skilled birth attendants and their supporters; to identify the factors influencing intrapartum and postnatal care delivery in low- and middle-income countries; and to assess how these factors are represented in intervention studies.

Qualitative methods were used, involving doctors, midwives, nurses, auxiliary nurses, and their managers, with 31 studies included.

The effectiveness of care provided by skilled birth attendants (SBAs) is influenced by several aspects, including their training, supervision, staffing levels, remuneration, housing circumstances, and the presence of well-equipped facilities. Furthermore, the efficacy of collaboration, reliance, and communication among healthcare professionals and with mothers is crucial in ensuring the quality of care. SBAs have documented difficulties linked to each of these criteria.

A27

Countries: Afghanistan, Bangladesh, Brazil, Ecuador, Fiji, Gambia, Ghana, Guatemala, Guinea, Haiti, India, Indonesia, Iran, Malawi, Mexico, Morocco, Pakistan, Philippines, Sierra Leone, South Africa, Uganda, Yemen, Zambia, and Zimbabwe [30]

To determine which low- and middle-income countries (LMICs) have midwife-led birthing centres and to identify their key characteristics.

A scoping survey of professional midwives’ associations was conducted in Part 2, while a scoping examination of the peer-reviewed and grey literature was conducted in Part 1. A protocol wasn’t released before this work was done. Responses to the polls, which included a structured online questionnaire, came from 77 of the 137 low- and middle-income nations in the globe—nurses who work as midwives.

Midwife-led birthing centers were more prevalent in low- and lower-middle-income countries compared to upper-middle-income nations. The majority of these centers operated as independent midwife-led facilities. In middle-income countries, birthing centers were more commonly managed by public-sector midwives, whereas in low-income settings, midwives often operated independently. In some cases, a multidisciplinary team of healthcare professionals collaborated, while in others, midwives were the sole providers of care. However, challenges persisted in establishing effective referral networks and fully integrating the midwifery care model into existing healthcare systems.

A28

Countries: Ghana, India, Bangladesh, Pakistan, Uganda, Malawi, Kenya, Tanzania, Ethiopia, Nepal, and Honduras [31]

To assess how crucial infant care measures are implemented in LMICs

Systematic Reviews and Meta-analyses (PRISMA), 43 articles, population newborns based quantitative and qualitative study designs, and databases including MEDLINE, EMBASE, CINAHL, Cochrane Central, and the Global Health Library.

This study identifies several barriers to learning from the implementation of ENC in LMICs, specifically highlighting the insufficient description of interventions and implementation outcomes. To decrease the number of deaths among newborns, it is crucial to find ways to improve the reporting of implementation studies in this area, which ultimately lead to better service delivery and outcomes.

A29

Countries: Senegal, Burkina Faso, Mozambique, Tanzania, Rwanda, Mali, Guinea-Bissau, Vietnam, Bangladesh, Nigeria, Angola, Uganda, Gambia, India, and Indonesia [32]

To examine quantitative data regarding the impact of various birthing attendance techniques in low-income environments on maternal health

Design: Systematic review using quantitative methods. The databases searched included MEDLINE, EMBASE, Cochrane Library, BIOSIS Previews, Web of Science, CINAHL, and POPLINE, with 29 articles included in the review.

Comparing studies was challenging due to inconsistencies in defining key concepts such as “skilled birth attendance” and the tendency to evaluate multiple interventions without isolating the effects of individual components. However, some studies identified promising factors, including cost, accessibility, widespread availability of essential medications, and the need for specialized training. These findings highlight the importance of developing clear conceptual frameworks to assess both individual interventions and comprehensive care models effectively.

A30

Countries: Afghanistan, Bangladesh, Benin, Brazil, Cambodia, Ghana, Guatemala, Iran, Kenya, Laos, Malawi, Morocco, Mozambique, Nepal, Nigeria, Pakistan, Palestine, Peru, Rwanda, South Africa, Uganda, and Vietnam [33]

Combining data on implementation hurdles and enablers for midwife-led care for pregnant women in low- and middle-income countries (LMICs) from the viewpoints of care recipients, providers, and other interested parties.

A mixed-methods systematic review included 31 studies. Of these, ten studies involved all three groups, five focused on care providers and stakeholders, and one study concentrated on care recipients and care providers.

Women need to possess knowledge to properly utilise midwife-led care, while strong education and supervision are essential for midwives. Collaboration and reliable financial support are crucial, but political instability can present considerable obstacles to implementation in LMICs.

A31

Countries: Rwanda, Afghanistan, Jordan, and Botswana [34]

To assess the existing knowledge on mentorship for healthcare professionals to improve the quality of care in low- and middle-income countries (LMICs).

Scoping reviews were performed by conducting searches on OVID Medline, CINAHL, and EMBASE. The population comprised individuals from various healthcare professions, including nurses, community health workers, medical staff, doctors, physicians, rural health personnel, physician assistants, field workers, and clinical officers. The review encompassed a total of 78 papers.

Tailored mentorship programs created to target specific objectives and educational needs can potentially enhance the quality of care. Training programs that enhance the capabilities of individuals are both more enduring and more effective in promoting decentralised primary health care.

A32

Countries: Sub-Sahara Afrika, Asia Selatan [2]

To perform a qualitative meta-summary of the experiences of parents and healthcare professionals about post-stillbirth care in low- and middle-income countries (LMICs).

A systematic review and meta-summary were conducted, with searches performed in databases including AMED, EMBASE, MEDLINE, PsychINFO, BNI, and CINAHL. A total of 118 full-text articles were included in the review.

Women undergo a range of different and frequently unacknowledged sorrow after experiencing a stillbirth, which can result in being stigmatised and a decline in their social standing. Health systems that are well-developed and staffed with trained personnel can offer essential assistance and knowledge. Simultaneously, even crucial measures can greatly improve the experiences of women and their families during this challenging period.

A33

Countries: Ghana, Nigeria, Gambia, Burkina Faso, Ivory Coast, and Uganda [35]

The purpose of obstetric first aid in the community is to serve as a strategic component of the “Partners in Safe Motherhood” campaign to diminish maternal mortality rates.

Two complementary instructional sessions. Maternity care providers

The authors emphasize the critical importance of emergency care training for both healthcare professionals and paraprofessionals. They argue that such training should be complemented by educational and community mobilization efforts targeting families, local communities, and traditional birth attendants (TBAs). Establishing a shared understanding of the necessity and appropriate methods for timely intervention is essential to reducing maternal mortality.

A34

Countries India [36]

The objective is to examine the correlation between age groups and the utilisation of maternal healthcare services in India while also accounting for individual, household, and environmental factors.

The cohorts for age at childbirth are categorised as follows: 15–24 years old, 25–34 years old, and 35–49 years old pregnant woman

The findings emphasize the importance of age-sensitive interventions that tailor programs and incentives to meet women’s healthcare needs at different stages of their reproductive lives. Prioritizing the provision of essential maternal healthcare services is particularly crucial for illiterate women, those with limited autonomy, and individuals from disadvantaged socioeconomic backgrounds.

A35

Countries Malawi, Rwanda, Tanzania, Uganda, Mozambique and South Africa [37]

To gather qualitative research data on the views and experiences of community health workers (CHWs) about supervision in maternal and child health (MCH) programs in low- and middle-income countries (LMICs).

Qualitative Methods; 19 papers; databases: EMBASE, Medline, PsycINFO, ASSIA, ERIC, and CINAHL; patient and client experiences were excluded.

Engaging community health workers (CHWs) and supervisors in developing supervision models could offer benefits. Supportive supervision is crucial for sustaining the motivation and performance of Community Health Workers (CHWs). However, CHWs often see supervision as irregular and primarily centred on fault-finding rather than offering assistance. Supervisors must undergo training in supportive supervision techniques and be provided with sufficient time and resources to conduct effective supervision in the field.

A36

Countries: Fiji [38]

To investigate the strategies employed by nursing leaders and managers in a developing nation to impact patient safety.

Nursing leaders and managers were interviewed using semi-structured interviews.

The findings reflect the necessity of investigating the working conditions of front-line nurses, the direct correlation between improved nursing conditions and enhanced patient safety, the empowerment of nursing leaders and managers, and a stronger emphasis on patient-centred care. These insights can improve the global nursing community’s ability to provide more effective support to advance a patient safety agenda.

A37

Countries: Indonesia [39]

To delineate the evolution and advancement of the healthcare system in Indonesia.

Qualitative research

Indonesia’s healthcare system revolves around the pivotal community-based health service called Puskesmas. According to the World Health Organization, around 64% of fatalities in Indonesia are attributed to noncommunicable illnesses, which may be associated with the inadequately organised prehospital care system.

A38

Countries: Sri Lanka and Mongolia [40]

The objective is to assess the viewpoints of local healthcare providers regarding the key areas that need improvement in maternity and neonatal departments.

Qualitative studies on maternity and newborn healthcare

Health practitioners from high-resource countries placed greater emphasis on organizational structures compared to their counterparts in low-resource settings, focusing on clearly defining roles and responsibilities. While staff education is widely recognized as the most critical strategy for enhancing the quality of maternity and neonatal care, significant discrepancies in workplace objectives continue to exist.

A39

Countries: Tanzania [41]

To comprehensively describe the healthcare practitioners (HCPs) in Tanzania who are recognised as skilled birth attendants (SBAs). It also discusses the emergency obstetric care (EmOC) signal functions that these SBAs undertake and the problems they have in carrying out these functions. We conducted a cross-sectional study on healthcare professionals (HCPs) who provide maternity care services at eight health facilities in Moshi Urban District in northern Tanzania.

A total of 199 individuals participated in a Cross-sectional study conducted in various medical facilities.

Healthcare providers at all levels have identified two major challenges: inadequate supplies and equipment, and a lack of sufficient knowledge and skills in delivering Emergency Obstetric Care (EmOC). Discrepancies were observed between the performance of skilled birth attendants (SBAs) in medical facilities and the expectations set by the Ministry of Health and Social Welfare (MOHSW) regarding their EmOC responsibilities. Many key EmOC facilities were not functioning at full capacity, and only a limited number of medical practitioners were able to effectively perform all essential EmOC procedures. Enhancing working conditions and implementing competency-based in-service training programs for EmOC providers could significantly strengthen EmOC services in the district.

A40

Countries: Greece [42]

The objective is to gather data on how countries have improved their healthcare systems and deployed midwives in nations with high maternal mortality rates.

A qualitative study on the health of mothers and newborns.

In these countries, the efforts to enhance the health system have been characterised by expanding the network of healthcare facilities and increasing the number of women who give birth in these facilities. Additionally, there has been a focus on increasing the production of midwives, reducing financial obstacles, and a lesser emphasis on improving the quality of care. The lack of attention given to respectful, woman-centred care and over-medicalization is evident.

A41

Countries: Indonesia and Nigeria [43]

The objective is to analyse the patterns and factors influencing the utilisation of skilled birth attendance (SBA) services during childbirth in a country in Southern Asia (SA) and another country in Sub-Saharan Africa (SSA) over the past two decades.

A total of 63,924 participants were included in a cross-sectional study. Females aged 15 to 49

Intervention initiatives focused on improving health literacy and education among vulnerable populations, particularly rural communities and uneducated mothers, can greatly enhance health outcomes. Addressing regional disparities and shortages in healthcare and educational resources requires strong partnerships with local communities, the private sector, and all levels of government. These collaborations are crucial in expanding access to skilled birth attendants (SBAs) and strengthening maternal healthcare services.

A42

Countries Ethiopia [44]

This study aims to examine the quality of prenatal care and its related factors among pregnant women receiving care at government hospitals in the Sidama Region of Southern Ethiopia.

A random selection strategy was used to choose 72 pregnant women for a cross-sectional study.

Women with higher educational attainment tend to demand higher-quality care due to their greater awareness of available services, more positive perceptions of healthcare, and ability to identify key qualities in service providers. Additionally, increased education empowers individuals with greater autonomy in making informed healthcare decisions.

Pregnant women who attended at least four antenatal care (ANC) visits at healthcare facilities and received guidance from medical professionals were more likely to access and benefit from high-quality medical interventions.

A43

Countries: Ghana and Tanzania [45]

This study aims to assess the initial level of routine antenatal and birth care in rural districts of Burkina Faso, Ghana, and Tanzania, as well as to identify any deficiencies or inadequacies.

A cross-sectional study was undertaken, encompassing a cohort of 63 postpartum women.

The findings reveal gaps in maternal healthcare services, including insufficient laboratory testing, inadequate counseling and health education programs, and poor monitoring and assessment of both the mother and infant during childbirth. Additionally, partographs were not utilized, and none of the assessed hospitals had forceps or vacuum extractors—both essential tools for assisted vaginal deliveries.