The experience of setting up midwife-led birth centers in Pakistan: a case study.
9 affiliations
- 1Research and Development Solutions (RADS), Islamabad, Pakistan.
- 2Research and Development Solutions (RADS), Islamabad, Pakistan. [email protected].
- 3Independent Consultant, Islamabad, Pakistan.
- 4Novametrics Ltd, Duffield, UK.
- 5University of Rwanda, Kigali, Rwanda.
- 6Independent Consultant, Cape Town, South Africa.
- 7Faculty of Health, University of Technology Sydney, Sydney, Australia.
- 8Burnet Institute, Melbourne, Australia.
- 9International Confederation of Midwives, The Hague, Netherlands.
Abstract
Introduction
Midwife-led birth centers (MLBCs) exist in Pakistan in various financial and operational capacities. Some operate independently, providing maternity services for a small user fee. Others operate through public-private partnerships involving collaboration between the government and NGOs. Currently, there is insufficient evidence available on the experiences of community midwives as maternal health care providers in MLBCs. There is also a lack of evidence about how midwives can operate in the private sector, although MLBCs are becoming more widespread nationwide. The study aimed to explore how MLBCs operate, to identify innovative approaches to improving women-centred care services.Methods
In-depth interviews were conducted with 6 stakeholders working in senior or leadership roles and 20 MLBC clients receiving maternity care services. Four Focus Group Discussions (FGDs) were organized with 25 individuals currently working as healthcare workers in MLBCs including midwives and nurses.Results
Five key themes were identified to describe MLBCs in Pakistan, especially women's experiences. The themes were (i) Having competent midwives, (ii) Providing comprehensive and accessible services that women need and want, (iii) Providing quality of care, (iv) Being disconnected from the healthcare system and (vi) Managing the cost.Conclusion
This study contributes to the understanding of MLBCs in Pakistan, their functioning, and providing quality, accessible, and affordable maternity care. Midwives provide humane and client-centered care at much lower prices, making their services accessible to a larger audience. The gap for women who want affordable high-quality care but cannot afford the premium fees of the private sector can be filled by establishing MLBCs and integrating them into the national health system. The policymakers and stakeholders should prioritize actionable steps in securing sustainable finance, continued medical, and integration of MLBCs into the larger public health system to harness the full potential of MLBCs in delivering high-quality, safe, and dignified maternity care to all, regardless of socioeconomic status.
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BibTeX
@article{naveed2026experience,
title = {{The experience of setting up midwife-led birth centers in Pakistan: a case study.}},
author = {Razia Naveed and Zainab Khawaja and Adnan Ahmad Khan and Tazleem Ayaz and Hania Rehman and Saad Ibrahim Rasheed and Ayza Sadaf Khawaja and Kirsty Hughes and Oliva Bazirete and Sofia Castro Lopes and Sabera Turkmani and Andrea Nove and Mandy Forrester and Caroline S E Homer},
journal = {BMC women's health},
year = {2026},
month = jul,
doi = {10.1186/s12905-026-04703-9},
url = {https://europepmc.org/article/MED/42907805},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The experience of setting up midwife-led birth centers in Pakistan: a case study.
AU - Razia Naveed
AU - Zainab Khawaja
AU - Adnan Ahmad Khan
AU - Tazleem Ayaz
AU - Hania Rehman
AU - Saad Ibrahim Rasheed
AU - Ayza Sadaf Khawaja
AU - Kirsty Hughes
AU - Oliva Bazirete
AU - Sofia Castro Lopes
AU - Sabera Turkmani
AU - Andrea Nove
AU - Mandy Forrester
AU - Caroline S E Homer
PY - 2026
DA - 2026/07/01
JO - BMC women's health
DO - 10.1186/s12905-026-04703-9
UR - https://europepmc.org/article/MED/42907805
AB - Introduction Midwife-led birth centers (MLBCs) exist in Pakistan in various financial and operational capacities. Some operate independently, providing maternity services for a small user fee. Others operate through public-private partnerships involving collaboration between the government and NGOs. Currently, there is insufficient evidence available on the experiences of community midwives as maternal health care providers in MLBCs. There is also a lack of evidence about how midwives can operate in the private sector, although MLBCs are becoming more widespread nationwide. The study aimed to explore how MLBCs operate, to identify innovative approaches to improving women-centred care services.Methods In-depth interviews were conducted with 6 stakeholders working in senior or leadership roles and 20 MLBC clients receiving maternity care services. Four Focus Group Discussions (FGDs) were organized with 25 individuals currently working as healthcare workers in MLBCs including midwives and nurses.Results Five key themes were identified to describe MLBCs in Pakistan, especially women's experiences. The themes were (i) Having competent midwives, (ii) Providing comprehensive and accessible services that women need and want, (iii) Providing quality of care, (iv) Being disconnected from the healthcare system and (vi) Managing the cost.Conclusion This study contributes to the understanding of MLBCs in Pakistan, their functioning, and providing quality, accessible, and affordable maternity care. Midwives provide humane and client-centered care at much lower prices, making their services accessible to a larger audience. The gap for women who want affordable high-quality care but cannot afford the premium fees of the private sector can be filled by establishing MLBCs and integrating them into the national health system. The policymakers and stakeholders should prioritize actionable steps in securing sustainable finance, continued medical, and integration of MLBCs into the larger public health system to harness the full potential of MLBCs in delivering high-quality, safe, and dignified maternity care to all, regardless of socioeconomic status.
SN - 1472-6874
ER -