Stakeholder perspectives on the effects of global health initiatives on the quality of maternal health services in government health facilities in the Elgon Region, Uganda: a qualitative descriptive study
6 affiliations
- 1Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- 2Seed Global Health, Kampala, Uganda
- 3Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- 4Institute for Health and Humanity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- 5Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
- 6School of Public Health, Faculty of Medicine and Health Sciences, University of Witwatersrand, Johannesburg, South Africa
Abstract
Introduction Global health initiatives (GHIs) are collaborative efforts that involve multiple stakeholders, including governments, international agencies, non-governmental organisations and philanthropic foundations, with the objective of addressing major global health challenges including maternal health. Quality of care plays a critical role in determining maternal health outcomes, and the WHO has established eight standards to guide the provision of care for mothers. This qualitative study therefore sought to examine stakeholders’ perspectives on the influence of GHIs on the quality of maternal health services in government health facilities within the Elgon Region of Uganda in line with these standards of care.Methods This study adopted a qualitative descriptive research design to explore how different stakeholders perceive and respond to the implications of GHIs on maternal health quality in the Elgon Region of Uganda. Key informant interviews were conducted among 17 participants purposively sampled to capture a range of institutional experiences and viewpoints.Results Stakeholders perceived that GHIs had contributed significantly to the reduction of HIV among newborns, reduction in malaria among pregnant women, trained health workers, improved service delivery for mothers, improved infrastructure and strengthened health systems in the region. All these significantly affect the quality of care mothers in the Elgon Region receive. Nevertheless, several implementation challenges were also identified, including limited local ownership, fragmented programme implementation, reliance on donor funding and weaknesses in governance and leadership. Stakeholders proposed several recommendations to address these issues, including the adoption of the ‘One Plan, One Budget, One Report’ framework, improved recruitment and performance management of health workers and greater integration of health services and GHI-supported interventions.Conclusions Stakeholders recognised the contribution of GHIs in several WHO standards, including the implementation of evidence-based interventions, the availability of well-trained and motivated health personnel, the provision of appropriate infrastructure, the use of health information systems and improved access to essential medical supplies. However, their influence was perceived to be limited or minimal in aspects such as referral systems, the provision of respectful and dignified care for women and their families and effective communication among health workers.
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BibTeX
@article{atuhairwe2026stakeholder,
title = {{Stakeholder perspectives on the effects of global health initiatives on the quality of maternal health services in government health facilities in the Elgon Region, Uganda: a qualitative descriptive study}},
author = {Irene Atuhairwe and Lydia Atuhaire and Constance S Shumba and Rose O Opio and Peter S Nyasulu},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-120777},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-120777},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Stakeholder perspectives on the effects of global health initiatives on the quality of maternal health services in government health facilities in the Elgon Region, Uganda: a qualitative descriptive study
AU - Irene Atuhairwe
AU - Lydia Atuhaire
AU - Constance S Shumba
AU - Rose O Opio
AU - Peter S Nyasulu
PY - 2026
DA - 2026/10/23
JO - BMJ Open
DO - 10.1136/bmjopen-2026-120777
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-120777
AB - Introduction Global health initiatives (GHIs) are collaborative efforts that involve multiple stakeholders, including governments, international agencies, non-governmental organisations and philanthropic foundations, with the objective of addressing major global health challenges including maternal health. Quality of care plays a critical role in determining maternal health outcomes, and the WHO has established eight standards to guide the provision of care for mothers. This qualitative study therefore sought to examine stakeholders’ perspectives on the influence of GHIs on the quality of maternal health services in government health facilities within the Elgon Region of Uganda in line with these standards of care.Methods This study adopted a qualitative descriptive research design to explore how different stakeholders perceive and respond to the implications of GHIs on maternal health quality in the Elgon Region of Uganda. Key informant interviews were conducted among 17 participants purposively sampled to capture a range of institutional experiences and viewpoints.Results Stakeholders perceived that GHIs had contributed significantly to the reduction of HIV among newborns, reduction in malaria among pregnant women, trained health workers, improved service delivery for mothers, improved infrastructure and strengthened health systems in the region. All these significantly affect the quality of care mothers in the Elgon Region receive. Nevertheless, several implementation challenges were also identified, including limited local ownership, fragmented programme implementation, reliance on donor funding and weaknesses in governance and leadership. Stakeholders proposed several recommendations to address these issues, including the adoption of the ‘One Plan, One Budget, One Report’ framework, improved recruitment and performance management of health workers and greater integration of health services and GHI-supported interventions.Conclusions Stakeholders recognised the contribution of GHIs in several WHO standards, including the implementation of evidence-based interventions, the availability of well-trained and motivated health personnel, the provision of appropriate infrastructure, the use of health information systems and improved access to essential medical supplies. However, their influence was perceived to be limited or minimal in aspects such as referral systems, the provision of respectful and dignified care for women and their families and effective communication among health workers.
SN - 2044-6055
SN - 2044-6055
ER -