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CONFERENCE PROCEEDING
Implementing midwife-led care in low-middle income countries: Lessons from two countries, a systematic review
1
Reprolife, Midwifery, Birmingham, Nigeria
Eur J Midwifery 2026;10(Supplement 1):A61
ABSTRACT
BACKGROUND:
In 2020, around 800 women died due to pregnancy and childbirth-related complications, with 95% of these deaths occurring in low-middle-income countries(LMIC). Southern Asia and Sub-Saharan Africa were estimated to account for 87% of global maternal deaths in 2020(World Health Organisation, 2023). Implementing Midwifery-led care (MLC) is supported by evidence as a low-cost strategy for reducing maternal and child mortality, even in LMIC (Michel-Schuldt et al., 2020). However, despite its proven cost-effectiveness, the implementation of MLC is not widespread in LMICs. Understanding the methods implemented in countries such as Bangladesh and India in implementing MLC can provide insights into replicable tools for upscaling and effectively reducing maternal and child mortality in other LMICs.
OBJECTIVES:
To identify and analyse the strategies and tools employed in Bangladesh and India to implement and adopt MLC.
METHODS:
A mixed-method review was undertaken, using a systematic approach to search databases, using inclusion and exclusion criteria to select data. Keywords were derived from the review question, which was defined in terms of Setting, Population/perspective, Intervention, Comparator, and Evaluation.
RESULTS:
This review, using the WHO Health Systems Thinking Framework, identified key factors in MLC implementation: respectful maternal care(rmc), mentoring, international-standard education, and strong legal frameworks. Bangladesh’s centralized system enabled smoother integration than India’s. Challenges included workforce shortages, limited leadership, poor community engagement, and inconsistent access to essential medicines.
CONCLUSIONS:
Successful MLC implementation in LMICs relies on strong policies, standardized education, mentoring, and systemic approaches. Bangladesh and India offer replicable models, but further research is needed on cost-effectiveness, outcomes, and financing. A coordinated, person-centered, integrated system is vital for global MLC scale-up and sustainability.
KEY MESSAGE:
Key success factors include rMC, mentoring, standardised education, and strong legal frameworks. Bangladesh’s centralized approach enabled smoother MLC integration. More evidence is needed on cost-effectiveness, outcomes, and sustainable financing in LMICs. Coordinated, person-centered systems are vital for global scale-up Continuity of care - implementation 2
In 2020, around 800 women died due to pregnancy and childbirth-related complications, with 95% of these deaths occurring in low-middle-income countries(LMIC). Southern Asia and Sub-Saharan Africa were estimated to account for 87% of global maternal deaths in 2020(World Health Organisation, 2023). Implementing Midwifery-led care (MLC) is supported by evidence as a low-cost strategy for reducing maternal and child mortality, even in LMIC (Michel-Schuldt et al., 2020). However, despite its proven cost-effectiveness, the implementation of MLC is not widespread in LMICs. Understanding the methods implemented in countries such as Bangladesh and India in implementing MLC can provide insights into replicable tools for upscaling and effectively reducing maternal and child mortality in other LMICs.
OBJECTIVES:
To identify and analyse the strategies and tools employed in Bangladesh and India to implement and adopt MLC.
METHODS:
A mixed-method review was undertaken, using a systematic approach to search databases, using inclusion and exclusion criteria to select data. Keywords were derived from the review question, which was defined in terms of Setting, Population/perspective, Intervention, Comparator, and Evaluation.
RESULTS:
This review, using the WHO Health Systems Thinking Framework, identified key factors in MLC implementation: respectful maternal care(rmc), mentoring, international-standard education, and strong legal frameworks. Bangladesh’s centralized system enabled smoother integration than India’s. Challenges included workforce shortages, limited leadership, poor community engagement, and inconsistent access to essential medicines.
CONCLUSIONS:
Successful MLC implementation in LMICs relies on strong policies, standardized education, mentoring, and systemic approaches. Bangladesh and India offer replicable models, but further research is needed on cost-effectiveness, outcomes, and financing. A coordinated, person-centered, integrated system is vital for global MLC scale-up and sustainability.
KEY MESSAGE:
Key success factors include rMC, mentoring, standardised education, and strong legal frameworks. Bangladesh’s centralized approach enabled smoother MLC integration. More evidence is needed on cost-effectiveness, outcomes, and sustainable financing in LMICs. Coordinated, person-centered systems are vital for global scale-up Continuity of care - implementation 2
| eISSN: | 2585-2906 |
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