Quality of Maternal and Newborn Care in Humanitarian and Crisis Settings in Sub‐Saharan Africa: An Umbrella Review
- 1Department of Midwifery, College of Health Science Mattu University Mattu Southwest Ethiopia
- 2Department of Biomedical Science, Faculty of Medical Sciences, Institute of Health Sciences Jimma University Jimma Southwest Ethiopia
- 3Department of Midwifery, College of Health Sciences Mada Walabu University Shashemene Southern Ethiopia
Abstract
Background and Aims: Humanitarian crises disrupt health systems, displace populations and limit access to essential services, threatening maternal and newborn survival in Sub Saharan Africa. Review level evidence on the quality of care in these settings is fragmented. This umbrella review aimed to synthesize evidence from systematic reviews on the quality of maternal and newborn care in humanitarian and crisis settings in Sub Saharan Africa, including dimensions of quality, barriers and facilitators, quality improvement strategies, and methodological gaps.
Methods: We searched nine databases and grey literature for reviews published from January 2015 to March 2026 (PROSPERO CRD420261396979; PRISMA 2020). Two reviewers independently screened records, extracted data and appraised methodological quality using AMSTAR 2. Overlap of primary studies was assessed with the corrected covered area. Findings were synthesized narratively by quality dimension. No meta‐analysis or hypothesis testing was performed.
Results: Of 1,284 records identified, 892 were screened after removing 392 duplicates, 74 full texts were assessed, and 12 records were included. AMSTAR 2 rated 4 of 12 as high quality, 6 moderate, 1 low and 1 critically low. Quality was compromised in effectiveness, safety, respectful care, equity, continuity and system readiness. Health system and supply barriers were reported in 8 of 12 records and insecurity related barriers in 7 of 12. Workforce training was the most frequent improvement strategy (6 of 12), mostly evaluated through process outcomes; evidence on mortality impact and long term neonatal outcomes was limited.
Conclusion: The quality of maternal and newborn care in humanitarian and crisis settings in sub‐Saharan Africa is compromised across multiple dimensions due to insecurity, displacement, workforce shortages, damaged infrastructure, and supply gaps. Context‐specific, respectful care and health system strengthening are needed, alongside improved evidence on neonatal care and long‐term outcomes.
PROSPERO Registration Number: CRD420261396979.
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BibTeX
@article{burayu2026quality,
title = {{Quality of Maternal and Newborn Care in Humanitarian and Crisis Settings in Sub‐Saharan Africa: An Umbrella Review}},
author = {Endale Tamiru Burayu and Zelalem Banjaw Zegeye and Gemechu Gelan Bekele},
journal = {Health Science Reports},
year = {2026},
month = nov,
doi = {10.1002/hsr2.73463},
url = {https://doi.org/10.1002/hsr2.73463},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Quality of Maternal and Newborn Care in Humanitarian and Crisis Settings in Sub‐Saharan Africa: An Umbrella Review
AU - Endale Tamiru Burayu
AU - Zelalem Banjaw Zegeye
AU - Gemechu Gelan Bekele
PY - 2026
DA - 2026/11/04
JO - Health Science Reports
DO - 10.1002/hsr2.73463
UR - https://doi.org/10.1002/hsr2.73463
AB - Background and Aims: Humanitarian crises disrupt health systems, displace populations and limit access to essential services, threatening maternal and newborn survival in Sub Saharan Africa. Review level evidence on the quality of care in these settings is fragmented. This umbrella review aimed to synthesize evidence from systematic reviews on the quality of maternal and newborn care in humanitarian and crisis settings in Sub Saharan Africa, including dimensions of quality, barriers and facilitators, quality improvement strategies, and methodological gaps. Methods: We searched nine databases and grey literature for reviews published from January 2015 to March 2026 (PROSPERO CRD420261396979; PRISMA 2020). Two reviewers independently screened records, extracted data and appraised methodological quality using AMSTAR 2. Overlap of primary studies was assessed with the corrected covered area. Findings were synthesized narratively by quality dimension. No meta‐analysis or hypothesis testing was performed. Results: Of 1,284 records identified, 892 were screened after removing 392 duplicates, 74 full texts were assessed, and 12 records were included. AMSTAR 2 rated 4 of 12 as high quality, 6 moderate, 1 low and 1 critically low. Quality was compromised in effectiveness, safety, respectful care, equity, continuity and system readiness. Health system and supply barriers were reported in 8 of 12 records and insecurity related barriers in 7 of 12. Workforce training was the most frequent improvement strategy (6 of 12), mostly evaluated through process outcomes; evidence on mortality impact and long term neonatal outcomes was limited. Conclusion: The quality of maternal and newborn care in humanitarian and crisis settings in sub‐Saharan Africa is compromised across multiple dimensions due to insecurity, displacement, workforce shortages, damaged infrastructure, and supply gaps. Context‐specific, respectful care and health system strengthening are needed, alongside improved evidence on neonatal care and long‐term outcomes. PROSPERO Registration Number: CRD420261396979.
SN - 2398-8835
ER -