ArticleBMC health services research2023
Midwife-led birthing centres in four countries: a case study.
Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Maternal Satisfaction With Midwives' Caregiving in Public Health Facilities: A Scoping Review.Cureus · 2026Review
- A survey of Ugandan skilled birth attendants regarding beliefs and management of gastroschisis.BMJ global health · 2026Article
- Towards developing new private sector maternity care models in South Africa: results from a deliberative stakeholder dialogue.Globalization and health · 2025Article
- Midwifery models of care in the context of increasing caesarean delivery rates.Bulletin of the World Health Organization · 2025Article
- Perspectives on midwife-led care as a solution to reduce obstetric violence in health facilities in Ghana.Frontiers in global women's health · 2025Article
- Increasing the number of midwives is necessary but not sufficient: using global data to support the case for investment in both midwife availability and the enabling work environment in low- and middle-income countries.Human resources for health · 2024Article
- Perceptions of quality of care in Midwife-led Birth Centres (MLBCs) in Uganda: Why do women choose MLBCs over other options?Women and birth : journal of the Australian College of Midwives · 2024Article
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Authors and funding
23 authors.
Funding
Abstract
backgroundMidwives are essential providers of primary health care and can play a major role in the provision of health care that can save lives and improve sexual, reproductive, maternal, newborn and adolescent health outcomes. One way for midwives to deliver care is through midwife-led birth centres (MLBCs). Most of the evidence on MLBCs is from high-income countries but the opportunity for impact of MLBCs in low- and middle-income countries (LMICs) could be significant as this is where most maternal and newborn deaths occur. The aim of this study is to explore MLBCs in four low-to-middle income countries, specifically to understand what is needed for a successful MLBC.
methodsA descriptive case study design was employed in 4 sites in each of four countries: Bangladesh, Pakistan, South Africa and Uganda. We used an Appreciative Inquiry approach, informed by a network of care framework. Key informant interviews were conducted with 77 MLBC clients and 33 health service leaders and senior policymakers. Fifteen focus group discussions were used to collect data from 100 midwives and other MLBC staff.
resultsKey enablers to a successful MLBC were: (i) having an effective financing model (ii) providing quality midwifery care that is recognised by the community (iii) having interdisciplinary and interfacility collaboration, coordination and functional referral systems, and (iv) ensuring supportive and enabling leadership and governance at all levels.
conclusionThe findings of this study have significant implications for improving maternal and neonatal health outcomes, strengthening healthcare systems, and promoting the role of midwives in LMICs. Understanding factors for success can contribute to inform policies and decision making as well as design tailored maternal and newborn health programmes that can more effectively support midwives and respond to population needs. At an international level, it can contribute to shape guidelines and strengthen the midwifery profession in different settings.
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