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Kassa ZY, Dadi AF, Bizuayehu HM, Hassen TA, Ahmed KY, Ketema DB, Amsalu E, Bore MG, Kibret GD, Alemu AA, Ayalew AA, Shifa JE, Bedaso A, Leshargie CT. Person-centred maternity care during childbirth: a systematic review in low and middle-income countries. BMC Pregnancy Childbirth 2025; 25:147. [PMID: 39939934 PMCID: PMC11817757 DOI: 10.1186/s12884-024-07133-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/31/2024] [Indexed: 02/14/2025] Open
Abstract
BACKGROUND Improving the quality of intrapartum and immediate postnatal care is critical for reducing maternal and neonatal mortality in low- and middle-income countries (LMICs). This review aimed to assess the extent of Person-Centred Maternity Care (PCMC) practices during childbirth in LMICs. METHODS We retrieved studies from four databases, including PubMed/Medline, Embase, CINAHL, and Maternal and Infant Care, up to 30 May 2023 and updated 26 April 2024. Additionally, manual searching was performed to identify additional studies. Our study included studies that examined PCMC using PCMC scale. The included studies were assessed using the Joanna Briggs Institute (JBI) checklist for quality appraisal. FINDINGS Twelve articles out of 888 were retained in the review. Among these, nine studies specifically examined various elements of PCMC, such as dignity and respect, communication and autonomy, and supportive care. The lowest and highest levels of the mean (± SD-standard deviation) PCMC were 46.5 (6.9) and 60.2 (12.3) out of 90 total scores in Ghana and urban Kenya, respectively. The lowest score was reported in the communication and autonomy subscale domain of PCMC at a mean (± SD) score of 8.3 (3.3). Women who were wealthier and educated, and those who received ANC and birthing care by the same health care providers were found to have a higher level of PCMC during childbirth. Whereas those women who did not have ANC follow-up, visited health facilities for ANC in the second or third trimester, stayed at health facilities after birth for 2-7 days, had complications, and received care from auxiliary midwives, nurses, or assisted by unskillled attendants were associated with a lower level of PCMC during childbirth. CONCLUSIONS Our findings indicated that the communication and autonomy components of PCMC are notably low, affecting the rapport between healthcare providers and women, as well as decision-making and the execution of procedures. To enhance PCMC, continuity of care through antenatal and intrapartum care provided by the same healthcare providers, along with fostering a supportive environment for both women and healthcare providers during childbirth is imperative. PROSPERO ID CRD42023426638.
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Affiliation(s)
- Zemenu Yohannes Kassa
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia.
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
| | - Abel F Dadi
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Habtamu Mellie Bizuayehu
- First Nations Cancer and Wellbeing (FNCW) Research Program, School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Tahir A Hassen
- Center for Women's Health Research, College of Health, Medicine and Wellbeing, the University of Newcastle, Newcastle, NSW, Australia
| | - Kedir Y Ahmed
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Sydney, NSW, Australia
| | - Daniel Bekele Ketema
- School of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- The George Institute for Global Health, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Erkihun Amsalu
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Meless G Bore
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia
| | - Getiye Dejenu Kibret
- School of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| | - Addisu Alehegn Alemu
- School of Women's and Children's Health, University of New South Wales, Kensington, Sydney, NSW, Australia
- College of Medicine and Health Sciences, Debre Markos University , Debre Markos, Ethiopia
| | - Animut Alebel Ayalew
- School of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- Palliative Care Outcomes Collaboration, Australasian Health Outcomes Consortium, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Jemal E Shifa
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, Australia
| | - Asres Bedaso
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council, Sydney, NSW, Australia
| | - Cheru Tesema Leshargie
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
- School of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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