INITIATIVES, PROGRAMS AND POLICIES THAT AIM TO INCREASE ACCESS TO MATERNAL HEALTH SERVICES IN WEST AND CENTRAL AFRICA: AN INTEGRATIVE LITERATURE REVIEW
Author(s)
Zilke Claessens, MSc, PhD1, Annette Eeraerts, MSc2, Isabelle Huys, PharmD, PhD2.
1PhD researcher, KU Leuven, Leuven, Belgium, 2KU Leuven, Leuven, Belgium.
1PhD researcher, KU Leuven, Leuven, Belgium, 2KU Leuven, Leuven, Belgium.
OBJECTIVES: West and Central Africa (WCA) accounts for 62.7% of maternal deaths in sub-Saharan Africa, yet the regional landscape of interventions targeting maternal health access remains poorly characterised. This study mapped initiatives, programmes and policies implemented between 2010 and 2025 across 24 WCA countries to identify intervention types, geographical distribution and evidence gaps.
METHODS: An integrative literature review was conducted following Whittemore and Knafl's methodology. PubMed, Scopus and Embase were systematically searched for peer-reviewed publications dated January 2010 to March 2025. Eligible records described interventions designed to expand access to maternal health services in any of 24 WCA countries. Data were extracted on intervention type, implementing actor, country, scale and reported outcomes.
RESULTS: Of 147 included articles, 86 distinct initiatives comprising 37 intervention types were identified across six categories: health financing (53.5%, n=46), health service delivery (40.7%, n=35), health workforce (31.4%, n=27), governance and policy (22.1%, n=19), digital health (12.8%, n=11) and transportation (10.5%, n=9). Most initiatives combined multiple intervention types. Performance-based financing dominated supply-side approaches, whereas fee exemption, conditional cash transfers and insurance characterised demand-side initiatives. Digital health and transportation rarely operated standalone and functioned predominantly as cross-cutting enablers. Distribution was uneven: Senegal exhibited the highest density (7.52 per 100 000 live births), whereas Nigeria recorded 0.27 per 100 000 despite the largest mortality burden; no qualifying initiatives were identified for Gabon or Equatorial Guinea.
CONCLUSIONS: Maternal health interventions in WCA cluster around financing and service delivery, with limited standalone investment in digital health and transportation. Marked country-level disparities indicate misalignment between intervention density and mortality burden, underscoring the need for context-adapted, equity-oriented investment in the most affected settings.
METHODS: An integrative literature review was conducted following Whittemore and Knafl's methodology. PubMed, Scopus and Embase were systematically searched for peer-reviewed publications dated January 2010 to March 2025. Eligible records described interventions designed to expand access to maternal health services in any of 24 WCA countries. Data were extracted on intervention type, implementing actor, country, scale and reported outcomes.
RESULTS: Of 147 included articles, 86 distinct initiatives comprising 37 intervention types were identified across six categories: health financing (53.5%, n=46), health service delivery (40.7%, n=35), health workforce (31.4%, n=27), governance and policy (22.1%, n=19), digital health (12.8%, n=11) and transportation (10.5%, n=9). Most initiatives combined multiple intervention types. Performance-based financing dominated supply-side approaches, whereas fee exemption, conditional cash transfers and insurance characterised demand-side initiatives. Digital health and transportation rarely operated standalone and functioned predominantly as cross-cutting enablers. Distribution was uneven: Senegal exhibited the highest density (7.52 per 100 000 live births), whereas Nigeria recorded 0.27 per 100 000 despite the largest mortality burden; no qualifying initiatives were identified for Gabon or Equatorial Guinea.
CONCLUSIONS: Maternal health interventions in WCA cluster around financing and service delivery, with limited standalone investment in digital health and transportation. Marked country-level disparities indicate misalignment between intervention density and mortality burden, underscoring the need for context-adapted, equity-oriented investment in the most affected settings.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EPH9
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Reproductive & Sexual Health