Community-Based Impact of Community-Based Antenatal Care Models on Prevention and Early Detection of Obstetric Complications: A Systematic Review.

Obstetric complications remain a leading cause of preventable maternal and neonatal morbidity and mortality in low- and middle-income countries (LMICs). Persistent barriers to facility-based antenatal care (ANC), including geographic remoteness, transportation costs, socio-cultural norms, and fragmented health systems, have prompted the large-scale expansion of community-based ANC models designed to bring preventive and early-detection services directly to underserved populations. This systematic review evaluated the impact of community-based ANC models on the prevention and early detection of obstetric complications in LMICs, compared maternal and neonatal outcomes with conventional facility-based care, and identified critical implementation gaps. A systematic review was conducted in accordance with PRISMA 2020 guidelines. Seven electronic databases, PubMed, CINAHL, Cochrane Library, WHO IRIS, Scopus, Embase, and Google Scholar, were searched for peer-reviewed studies published between 2000 and 2025. Studies were screened against predefined inclusion and exclusion criteria, and 40 studies that met these criteria were included. Data were synthesised both narratively and quantitatively. The study concluded that 40 included studies (77.5%) reported significant improvements in preventive maternal health practices, including anaemia screening, blood pressure monitoring, and birth preparedness, attributable to community-based interventions. Early ANC initiation improved in 82.5% of studies, with referral compliance increasing by 18%-38% in community-supported models. Neonatal mortality reductions of 15%-24% were documented in participatory women's group interventions. However, 65% of studies identified implementation challenges, including weak referral systems, inadequate community health worker (CHW) supervision, supply chain inconsistencies, and entrenched socio-cultural barriers. Community-based ANC models greatly improve prevention and early detection of obstetric complications, especially in rural and resource-limited areas. Their effectiveness is maximised when they are organisationally integrated with primary healthcare systems, supported by strong referral connections, and tailored to local contexts. Expanding these models requires ongoing investment in the workforce, training, and coordination mechanisms for community facilities.