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Experiences of health facility childbirth in Sub-Saharan Africa: a systematic review of qualitative evidence

Gwacham-Anisiobi, Uchenna and Banke-Thomas, Aduragbemi ORCID: 0000-0002-4449-0131 (2022) Experiences of health facility childbirth in Sub-Saharan Africa: a systematic review of qualitative evidence. Maternal and Child Health Journal, 26 (3). 481 - 492. ISSN 1092-7875

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Identification Number: 10.1007/s10995-022-03383-9


Introduction: Access to skilled birth attendance has been prioritised as an intervention to minimise burden of maternal deaths in sub-Saharan Africa (SSA). However, poor experience of care (EoC) is impeding progress. We conducted a systematic review to holistically explore EoC patterns of facility-based childbirth in SSA. Methods: PubMed, Embase and Scopus databases were searched to identify SSA EoC studies conducted between January 2000 and December 2019. Studies meeting our pre-defined inclusion criteria were quality assessed and relevant data extracted. We utilised the EoC quality standards (defined by the World Health Organization) to summarise and analyse findings while highlighting patterns. Results: Twenty-two studies of varying quality from 11 SSA countries were included for review. Overall, at least one study from all included countries reported negative EoC in one or more domains of the WHO framework. Across SSA, ‘respect and preservation of dignity’ was the most reported domain of EoC. While most women deemed the pervasive disrespect as unacceptable, studies in West Africa suggest a “normalisation” of disrespect, if the intent is to save their lives. Women often experienced sub-optimal communication and emotional support with providers in public facilities compared to non-public ones in the region. These experiences had an influence on future institutional deliveries. Discussion: Sub-optimal EoC is widespread in SSA, more so in public facilities. As SSA heath systems explore approaches make progress towards the Sustainable Development Goal 3, emphasis needs to be placed on ensuring women in the region have access to both high-quality provision and experience of care.

Item Type: Article
Official URL:
Additional Information: © 2022 The Authors
Divisions: Health Policy
Subjects: R Medicine > RG Gynecology and obstetrics
R Medicine > RA Public aspects of medicine
Date Deposited: 11 Mar 2022 10:57
Last Modified: 17 Mar 2022 09:24

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