Prevalence of person-centered maternity care during childbirth and its predictors among women who gave birth in health facilities of East Africa: A systematic review and meta-analysis.

Abstract

Poor quality care significantly contributes to preventable maternal morbidity and mortality in sub-Saharan Africa, where respectful and responsive childbirth care remains variable. Person-centered maternity care (PCMC) is a crucial element of the WHO maternal and newborn quality-of-care framework; however, region-specific synthesis is lacking. This review aimed to estimate the pooled mean PCMC score and identify its predictors among postpartum women in East Africa. We systematically searched PubMed, Research4Life, ScienceDirect, DOAJ, and Google Scholar for observational studies conducted from 2017 to 2025. Study quality was appraised using the Joanna Briggs Institute critical appraisal checklist. Random-effects meta-analysis using the DerSimonian-Laird estimator was performed, and subgroup and meta-regression analyses were used to explore heterogeneity. Twenty three studies involving 15,325 women were included. The pooled mean PCMC score in East Africa was 63.08% (95% CI: 59.19, 66.97). Domain-specific scores were highest for dignity and respect (78.05%; 95% CI: 74.43-81.67), followed by supportive care (62.59%; 95% CI: 59.44-65.73), and lowest for communication and autonomy (55.29%; 95% CI: 48.66-61.92), demonstrating significant gaps in provider-patient communication and shared decision-making. Lower PCMC scores were associated with nighttime delivery (β = -2.23; 95% CI: -3.35, -1.11), third-trimester antenatal care initiation (β = -4.06; 95% CI: -7.74, -0.38), and rural residence (β = -1.61; 95% CI: -2.60, -0.61), while higher maternal education was positively associated with PCMC. PCMC in East Africa remains suboptimal, predominantly in the communication, autonomy, and supportive care domains. Reinforcing provider communication and shared decision-making skills, improving night-shift staffing and supervision, integrating PCMC indicators into quality monitoring systems, and expanding community-level interventions through task-shifting and community engagement strategies are recommended. Future research should prioritize implementation and intervention studies targeting identified gaps. The protocol has been registered in PROSPERO (CRD42024576229).