Maternity Protection in the Global South – Where are the shortfalls? Evidence on Workplace Breastfeeding Support Across Low and Middle Income Countries
1
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
2
School of Health Sciences, University of Kwazulu-Natal, Durban, South Africa
3
School of Management Studies, Faculty of Commerce, University of Cape Town, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2354
ABSTRACT
INTRODUCTION:
Returning to work remains a barrier to exclusive breastfeeding to six months, contributing to early cessation worldwide1. Evidence from high-income countries demonstrates that workplace support improves breastfeeding practices, yet 85% of the global population lives in low- and middle-income countries (LMIC) where work environments, norms, and policies differ. Evidence from LMIC is sparse and fragmented, limiting guidance for context-appropriate policies2-6. Clarifying the existing evidence is critical to designing solutions that protect the health of working mothers and their newborns.
METHODS:
We conducted a scoping review to map research on workplace breastfeeding support in LMIC since 2016, following PRISMA-ScR and JBI guidelines. Of 35, 049 records identified, 128 met inclusion criteria (by including working mothers, their partners, employers or policymakers, addressing any aspect of workplace support).
RESULTS:
The 128 studies represented 25 LMIC; half were quantitative, 41.4% qualitative, and 8.6% mixed methods. Among 118 primary data studies, most were work-focused (72.9%), while 27.1% were work-included. Most research centred on formal sectors (59.3%). Our analysis yielded four overarching themes: (1) Much research is decontextualised (e.g., inadequate adaptation of data collection tools) (2) Research aims often appear misplaced (e.g., a focus on healthcare workers as a study population; insufficient consideration of structural breastfeeding support such as paid maternity leave). (3) A strong individual focus on increased education or building resilience of women and mothers, when structural solutions would have more impact. (4) Insufficient focus on vulnerable workers (e.g., those in precarious or informal work).
CONCLUSIONS:
Evidence gaps persist, including among precarious employment, evaluations of interventions and policy implementation. Accelerated progress toward global maternal and newborn health goals requires investment in context-specific research to inform equitable, scalable workplace breastfeeding support7-9. Strengthening workplace support can improve infant feeding, advance women’s economic participation, yielding long-term health and development benefits for mothers, newborns, and communities.
Returning to work remains a barrier to exclusive breastfeeding to six months, contributing to early cessation worldwide1. Evidence from high-income countries demonstrates that workplace support improves breastfeeding practices, yet 85% of the global population lives in low- and middle-income countries (LMIC) where work environments, norms, and policies differ. Evidence from LMIC is sparse and fragmented, limiting guidance for context-appropriate policies2-6. Clarifying the existing evidence is critical to designing solutions that protect the health of working mothers and their newborns.
METHODS:
We conducted a scoping review to map research on workplace breastfeeding support in LMIC since 2016, following PRISMA-ScR and JBI guidelines. Of 35, 049 records identified, 128 met inclusion criteria (by including working mothers, their partners, employers or policymakers, addressing any aspect of workplace support).
RESULTS:
The 128 studies represented 25 LMIC; half were quantitative, 41.4% qualitative, and 8.6% mixed methods. Among 118 primary data studies, most were work-focused (72.9%), while 27.1% were work-included. Most research centred on formal sectors (59.3%). Our analysis yielded four overarching themes: (1) Much research is decontextualised (e.g., inadequate adaptation of data collection tools) (2) Research aims often appear misplaced (e.g., a focus on healthcare workers as a study population; insufficient consideration of structural breastfeeding support such as paid maternity leave). (3) A strong individual focus on increased education or building resilience of women and mothers, when structural solutions would have more impact. (4) Insufficient focus on vulnerable workers (e.g., those in precarious or informal work).
CONCLUSIONS:
Evidence gaps persist, including among precarious employment, evaluations of interventions and policy implementation. Accelerated progress toward global maternal and newborn health goals requires investment in context-specific research to inform equitable, scalable workplace breastfeeding support7-9. Strengthening workplace support can improve infant feeding, advance women’s economic participation, yielding long-term health and development benefits for mothers, newborns, and communities.
| eISSN: | 2654-1459 |
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