Navigating Care: Women’s Experiences of Seeking Childbirth Services in Low- and Middle-Income Countries (LMICs): A Systematic Review
1
School of Health Science, University of Nottingham, Nottingham, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
A comprehensive understanding of maternal mortality, its causes, and underlying determinants is needed. Inadequate protocols and a lack of information sharing are likely to cause delays in emergency care and management, leading to maternal deaths. Delays in detecting complications and making decisions are major contributors to high maternal deaths in low- and middle-income countries (LMICs). The interactive decision-making process within families, involving the woman, her partner, and other family members, may contribute to this delay. Previous research indicates that cultural and customary factors may impact the ability to seek care during childbirth. Sociocultural views and practices, lack of understanding about complications during pregnancy and childbirth, and husbands or other family members determining the decision-making in the household are all social factors that may have an impact on seeking care and related maternal health outcomes. This study aims to synthesise published and unpublished qualitative research that explores women’s experiences of seeking care during childbirth in low- and middle-income countries.
METHODS:
Studies were screened from multiple electronic databases by title, abstract, and full text, after which a standardised qualitative checklist was used to assess study quality.
RESULTS:
Fourteen eligible studies from LMIC settings were identified. Key themes from research evidence findings included five main themes: 1) Birth attendant and place of birth preferences; 2) Sociocultural and family factors; 3) Communication and information provision; 4) Disrespect and abuse; 5) Barriers in seeking care during childbirth.
CONCLUSIONS:
The interplay of structural, interpersonal, and socio-cultural factors shapes women’s experiences of seeking childbirth care in LMICs. Efforts to improve maternal health must go beyond addressing access and affordability, and also prioritise respectful, person-centred, and culturally sensitive care. Integrated interventions that combine financial and transport support with strategies to promote respectful maternity care and community engagement are essential to improve both utilisation and satisfaction with services.
A comprehensive understanding of maternal mortality, its causes, and underlying determinants is needed. Inadequate protocols and a lack of information sharing are likely to cause delays in emergency care and management, leading to maternal deaths. Delays in detecting complications and making decisions are major contributors to high maternal deaths in low- and middle-income countries (LMICs). The interactive decision-making process within families, involving the woman, her partner, and other family members, may contribute to this delay. Previous research indicates that cultural and customary factors may impact the ability to seek care during childbirth. Sociocultural views and practices, lack of understanding about complications during pregnancy and childbirth, and husbands or other family members determining the decision-making in the household are all social factors that may have an impact on seeking care and related maternal health outcomes. This study aims to synthesise published and unpublished qualitative research that explores women’s experiences of seeking care during childbirth in low- and middle-income countries.
METHODS:
Studies were screened from multiple electronic databases by title, abstract, and full text, after which a standardised qualitative checklist was used to assess study quality.
RESULTS:
Fourteen eligible studies from LMIC settings were identified. Key themes from research evidence findings included five main themes: 1) Birth attendant and place of birth preferences; 2) Sociocultural and family factors; 3) Communication and information provision; 4) Disrespect and abuse; 5) Barriers in seeking care during childbirth.
CONCLUSIONS:
The interplay of structural, interpersonal, and socio-cultural factors shapes women’s experiences of seeking childbirth care in LMICs. Efforts to improve maternal health must go beyond addressing access and affordability, and also prioritise respectful, person-centred, and culturally sensitive care. Integrated interventions that combine financial and transport support with strategies to promote respectful maternity care and community engagement are essential to improve both utilisation and satisfaction with services.
| eISSN: | 2654-1459 |
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