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Midwife-led birthing centres in low- and middle-income countries

Project Member(s): Scarf, V., Homer, C., Turkmani, S.

Funding or Partner Organisation: Macfarlane Burnet Institute for Medical Research & Public Health (Macfarlane Burnet Institute for Medical Research and Public Health)
Bill and Melinda Gates Foundation (Bill & Melinda Gates Foundation - Grand Challenges in Global Health)

Start year: 2022

Summary: Midwives have the potential to save lives of women and children at scale. A recent Lancet Global Health report on 88 low-income and middle-income (LMIC) countries estimated 67% of maternal deaths, 64% of neonatal deaths, and 65% of stillbirths could be avoided by the universal provision of care by midwives. There has been a global shift from home to facility-based care however, a notable unintended consequence of this shift that drove the relative success of Millennium Development Goal 5, poses several risks to mothers and babies including overmedicalization of birth, disrespectful care practices and in many cases has not led to the projected lowering of maternal and perinatal mortality. Midwife-led care within the context of Midwife-led birthing Centres offers a middle path by reducing the likelihood of potentially harmful interventions while providing access to higher level emergency obstetric care particularly in settings where universal access to higher level facility-based care is limited. This leads to a critical need to examine MLBCs in low- and middle-income countries where 99% of global maternal and neonatal deaths continue to occur. This research project will explore ‘what works’ and ‘why’ in relation to midwife-led birth centres (MLBCs) in low- and middle-income countries (LMICs). The overall approach will be guided by the “network of care” (NOC) framework. While this concept is not specific to maternal and newborn health, it has been suggested that failures of NOCs are a significant reason for relatively slow progress on reducing maternal and newborn mortality despite increasing rates of skilled birth attendance.

FOR Codes: Women's and maternal health, Midwifery