Midwife-led birthing centres in four countries: a case study.

Bazirete, O; Hughes, K; Lopes, SC; Turkmani, S; Abdullah, AS; Ayaz, T; Clow, SE; Epuitai, J; Halim, A; Khawaja, Z; Mbalinda, SN; Minnie, K; Nabirye, RC; Naveed, R; Nawagi, F; Rahman, F; Rasheed, SI; Rehman, H; Nove, A; Forrester, M; Mandke, S; Pairman, S; Homer, CSE

Midwife-led birthing centres in four countries: a case study.

Bazirete, O Hughes, K Lopes, SC Turkmani, S

Abdullah, AS Ayaz, T Clow, SE Epuitai, J Halim, A Khawaja, Z Mbalinda, SN Minnie, K Nabirye, RC Naveed, R Nawagi, F Rahman, F Rasheed, SI Rehman, H Nove, A Forrester, M Mandke, S Pairman, S Homer, CSE

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Publisher:: BMC
Publication Type:: Journal Article
Citation:: BMC Health Serv Res, 2023, 23, (1), pp. 1105
Issue Date:: 2023-10-17

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Field	Value	Language
dc.contributor.author	Bazirete, O
dc.contributor.author	Hughes, K
dc.contributor.author	Lopes, SC
dc.contributor.author	Turkmani, S https://orcid.org/0000-0001-7819-5061
dc.contributor.author	Abdullah, AS
dc.contributor.author	Ayaz, T
dc.contributor.author	Clow, SE
dc.contributor.author	Epuitai, J
dc.contributor.author	Halim, A
dc.contributor.author	Khawaja, Z
dc.contributor.author	Mbalinda, SN
dc.contributor.author	Minnie, K
dc.contributor.author	Nabirye, RC
dc.contributor.author	Naveed, R
dc.contributor.author	Nawagi, F
dc.contributor.author	Rahman, F
dc.contributor.author	Rasheed, SI
dc.contributor.author	Rehman, H
dc.contributor.author	Nove, A
dc.contributor.author	Forrester, M
dc.contributor.author	Mandke, S
dc.contributor.author	Pairman, S
dc.contributor.author	Homer, CSE
dc.date.accessioned	2024-01-08T22:35:33Z
dc.date.available	2023-10-06
dc.date.available	2024-01-08T22:35:33Z
dc.date.issued	2023-10-17
dc.identifier.citation	BMC Health Serv Res, 2023, 23, (1), pp. 1105
dc.identifier.issn	1472-6963
dc.identifier.issn	1472-6963
dc.identifier.uri	http://hdl.handle.net/10453/174112
dc.description.abstract	BACKGROUND: Midwives 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. METHODS: A 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. RESULTS: Key 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. CONCLUSION: The 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.
dc.format	Electronic
dc.language	eng
dc.publisher	BMC
dc.relation	http://purl.org/au-research/grants/nhmrc/2016379
dc.relation.ispartof	BMC Health Serv Res
dc.relation.isbasedon	10.1186/s12913-023-10125-2
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	0807 Library and Information Studies, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Health Policy & Services
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4205 Nursing
dc.subject.classification	4206 Public health
dc.subject.mesh	Pregnancy
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Humans
dc.subject.mesh	Adolescent
dc.subject.mesh	Female
dc.subject.mesh	Midwifery
dc.subject.mesh	Birthing Centers
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Leadership
dc.subject.mesh	Referral and Consultation
dc.subject.mesh	Humans
dc.subject.mesh	Leadership
dc.subject.mesh	Midwifery
dc.subject.mesh	Pregnancy
dc.subject.mesh	Adolescent
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Birthing Centers
dc.subject.mesh	Referral and Consultation
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Female
dc.subject.mesh	Pregnancy
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Humans
dc.subject.mesh	Adolescent
dc.subject.mesh	Female
dc.subject.mesh	Midwifery
dc.subject.mesh	Birthing Centers
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Leadership
dc.subject.mesh	Referral and Consultation
dc.title	Midwife-led birthing centres in four countries: a case study.
dc.type	Journal Article
utslib.citation.volume	23
utslib.location.activity	England
utslib.for	0807 Library and Information Studies
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
utslib.copyright.status	open_access	*
dc.date.updated	2024-01-08T22:35:32Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	23
utslib.citation.issue	1

Abstract:

BACKGROUND: Midwives 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. METHODS: A 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. RESULTS: Key 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. CONCLUSION: The 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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http://hdl.handle.net/10453/174112