Banke-Thomas, Aduragbemi ORCID: https://orcid.org/0000-0002-4449-0131 and Gwacham‑Anisiob, Uchenna (2022) Experiences of health facility childbirth in sub-Saharan Africa: a systematic review of qualitative evidence. Maternal and Child Health, 26 (3). pp. 481-492. ISSN 1092-7875 (Print), 1573-6628 (Online) (doi:10.1007/s10995-022-03383-9)

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Abstract

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
Uncontrolled Keywords:	maternal health; experience; sub-Saharan Africa
Subjects:	R Medicine > RG Gynecology and obstetrics R Medicine > RT Nursing
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	13 May 2022 08:52
URI:	http://gala.gre.ac.uk/id/eprint/35253

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