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CONFERENCE PROCEEDING
Implementation of midwife-led continuity of care model in Ethiopia
1
Debre Berhan University, Midwifery, Debre Berhan, Ethiopia
Eur J Midwifery 2026;10(Supplement 1):A294
ABSTRACT
BACKGROUND:
The midwife-led continuity of care (MLCC) model, widely adopted in high-income countries, provides continuous care to women throughout pregnancy, childbirth, and the early postnatal period from a known midwife or small team. While MLCC is associated with improved maternal and neonatal outcomes and higher satisfaction in high-resource settings, its effectiveness in low- and middle-income countries remains underexplored.
OBJECTIVES:
This study aimed to evaluate the impact of the MLCC model on maternal and neonatal outcomes, service utilization, and maternal satisfaction in North Shoa Zone, Amhara Region, Ethiopia.
METHODS:
Between August 2019 and September 2020, a quasi-experimental study was conducted in four primary hospitals involving 1,178 low-risk pregnant women. Participants were assigned to either the MLCC group or the standard Shared Model of Care (SMC), with 589 women in each group. MLCC participants received care from a consistent midwife or a backup, from antenatal care through labor, birth, and postnatal care. Midwives (4–8 per facility) were trained on the model’s philosophy and assigned to 37–38 women each. The SMC group received fragmented care from multiple providers. Qualitative interviews with providers supported understanding of the implementation process.
RESULTS:
MLCC significantly improved maternal and neonatal outcomes. Spontaneous vaginal births increased, while preterm births dropped by 61%, vacuum-assisted deliveries by 58%, and episiotomies by 74%. Early initiation of breastfeeding improved, and low Apgar scores at 5 minutes decreased by 59%. NICU admissions fell by 50%. Maternal satisfaction increased by 87%, and MLCC women were more likely to complete four or more ANC visits and three or more PNC visits. Notably, 97% of women in MLCC were attended by the same midwife during birth.
CONCLUSIONS:
MLCC demonstrates promising results in improving outcomes and satisfaction in low-resource settings. Scale-up and feasibility assessments are recommended for broader implementation in Ethiopia.
KEY MESSAGE:
Midwifery model of care, continuity of care, maternal and neonatal outcomes, Ethiopia Maternal mortality
The midwife-led continuity of care (MLCC) model, widely adopted in high-income countries, provides continuous care to women throughout pregnancy, childbirth, and the early postnatal period from a known midwife or small team. While MLCC is associated with improved maternal and neonatal outcomes and higher satisfaction in high-resource settings, its effectiveness in low- and middle-income countries remains underexplored.
OBJECTIVES:
This study aimed to evaluate the impact of the MLCC model on maternal and neonatal outcomes, service utilization, and maternal satisfaction in North Shoa Zone, Amhara Region, Ethiopia.
METHODS:
Between August 2019 and September 2020, a quasi-experimental study was conducted in four primary hospitals involving 1,178 low-risk pregnant women. Participants were assigned to either the MLCC group or the standard Shared Model of Care (SMC), with 589 women in each group. MLCC participants received care from a consistent midwife or a backup, from antenatal care through labor, birth, and postnatal care. Midwives (4–8 per facility) were trained on the model’s philosophy and assigned to 37–38 women each. The SMC group received fragmented care from multiple providers. Qualitative interviews with providers supported understanding of the implementation process.
RESULTS:
MLCC significantly improved maternal and neonatal outcomes. Spontaneous vaginal births increased, while preterm births dropped by 61%, vacuum-assisted deliveries by 58%, and episiotomies by 74%. Early initiation of breastfeeding improved, and low Apgar scores at 5 minutes decreased by 59%. NICU admissions fell by 50%. Maternal satisfaction increased by 87%, and MLCC women were more likely to complete four or more ANC visits and three or more PNC visits. Notably, 97% of women in MLCC were attended by the same midwife during birth.
CONCLUSIONS:
MLCC demonstrates promising results in improving outcomes and satisfaction in low-resource settings. Scale-up and feasibility assessments are recommended for broader implementation in Ethiopia.
KEY MESSAGE:
Midwifery model of care, continuity of care, maternal and neonatal outcomes, Ethiopia Maternal mortality
| eISSN: | 2585-2906 |
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