‘They should listen to what we want’: striving for woman-centred intrapartum care in Sudan’s fragile healthcare system, a qualitative interpretive study
- 1The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, Australia
- 2Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
Abstract
Background: Woman-centred care is recognised globally as crucial for improving maternal health outcomes. However, its implementation in fragile healthcare systems presents unique challenges. This study explored how Sudanese women view and experience quality intrapartum care within the context of a fragile healthcare system.
Methods: We undertook a qualitative interpretative study in Khartoum state, Sudan. We conducted semi-structured interviews with 18 women who had given birth in healthcare facilities within the previous year. We recruited participants from both urban and semi-rural settings. We analysed the data using the framework method.
Results: Poor quality intrapartum care resulted from systemic issues and embedded culture rather than individual behaviours. Key challenges included disrespectful care, inadequate pain management, and limited emotional support. Significant disparities existed between public and private healthcare facilities, with public hospitals characterised by poor infrastructure, limited resources, and disrespectful care. Power imbalances between women and healthcare providers undermined the provision of woman-centred care, particularly in public hospitals. The normalisation of informal payments created additional barriers to accessing quality care. However, women identified opportunities for improvement through enhanced engagement in care decisions and strengthened feedback mechanisms.
Conclusion: Despite Sudan’s fragile healthcare context, opportunities exist to enhance woman-centred intrapartum care through systemic changes. Priority areas include addressing public-private care disparities, rebalancing power dynamics, improving physical environments, and actively engaging women in their care. Improving care requires a comprehensive approach incorporating community engagement, provider training, and health system strengthening within resource constraints.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09728-4.
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BibTeX
@article{ahmed2026they,
title = {{‘They should listen to what we want’: striving for woman-centred intrapartum care in Sudan’s fragile healthcare system, a qualitative interpretive study}},
author = {Salma A.E. Ahmed and Abela Mahimbo and Heitham Awadalla and Angela Dawson},
journal = {BMC Pregnancy and Childbirth},
year = {2026},
month = aug,
doi = {10.1186/s12884-026-09728-4},
url = {https://doi.org/10.1186/s12884-026-09728-4},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - ‘They should listen to what we want’: striving for woman-centred intrapartum care in Sudan’s fragile healthcare system, a qualitative interpretive study
AU - Salma A.E. Ahmed
AU - Abela Mahimbo
AU - Heitham Awadalla
AU - Angela Dawson
PY - 2026
DA - 2026/08/01
JO - BMC Pregnancy and Childbirth
DO - 10.1186/s12884-026-09728-4
UR - https://doi.org/10.1186/s12884-026-09728-4
AB - Background: Woman-centred care is recognised globally as crucial for improving maternal health outcomes. However, its implementation in fragile healthcare systems presents unique challenges. This study explored how Sudanese women view and experience quality intrapartum care within the context of a fragile healthcare system. Methods: We undertook a qualitative interpretative study in Khartoum state, Sudan. We conducted semi-structured interviews with 18 women who had given birth in healthcare facilities within the previous year. We recruited participants from both urban and semi-rural settings. We analysed the data using the framework method. Results: Poor quality intrapartum care resulted from systemic issues and embedded culture rather than individual behaviours. Key challenges included disrespectful care, inadequate pain management, and limited emotional support. Significant disparities existed between public and private healthcare facilities, with public hospitals characterised by poor infrastructure, limited resources, and disrespectful care. Power imbalances between women and healthcare providers undermined the provision of woman-centred care, particularly in public hospitals. The normalisation of informal payments created additional barriers to accessing quality care. However, women identified opportunities for improvement through enhanced engagement in care decisions and strengthened feedback mechanisms. Conclusion: Despite Sudan’s fragile healthcare context, opportunities exist to enhance woman-centred intrapartum care through systemic changes. Priority areas include addressing public-private care disparities, rebalancing power dynamics, improving physical environments, and actively engaging women in their care. Improving care requires a comprehensive approach incorporating community engagement, provider training, and health system strengthening within resource constraints. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09728-4.
SN - 1471-2393
ER -