Respectful Maternity Care in Sub-Saharan Africa: A Scoping Review of Disrespect, Abuse, and Inequities in Maternal Health Services
Abstract
Background: Respectful maternity care (RMC) is a fundamental human right and a prerequisite for high-quality maternity care. However, attempts to improve maternal outcomes are weakened because mothers in Sub-Saharan Africa (SSA) continue to face unfair treatment, abuse, neglect, and disrespect during the delivery process. Inadequate maternity care discourages mothers from using medical facilities, raises maternal morbidity and mortality rates, and lowers global goals for safe motherhood. Objectives: The objectives of this scoping review were to identify the current evidence on implementation, barriers, and facilitators of RMC in SSA, published in 20062025, and gaps to be utilised in subsequent research and policy formulation. Methods: Using the PRISMA-ScR (Preferred Reporting Items to Systematic Reviews and Meta-Analyses extension to Scoping Reviews) framework, a systematic search was conducted from October 5–November 1, 2025, in PubMed, CINAHL, Scopus, Web of Science, and the Cochrane Library. Grey literature was acquired from the WHO, UNFPA, and government repositories. Peer-reviewed and grey literature that concerned RMC practices, experiences, or policies within SSA were included as criteria. Narrative synthesis was used to extract and chart out data in themes. Results: A total of 87 studies were eligible out of 3,284 records found. Thematic synthesis identified five themes that were most commonly present, such as (1) high rates of disrespect and maltreatment during facility-based childbirth, (2) sociocultural and systemic causes of mistreatment, (3) effective RMC interventions such as provider education and policy frameworks, (4) ongoing inequities in marginalized populations, and (5) accountability and responsiveness of the health system. In spite of the improvement, there are still unaddressed shortcomings in implementation fidelity, RMC outcomes measurement, and inclusion of male partners. Conclusion: Good maternity care has been a sporadic practice in SSA despite the heightened awareness. Long-term change requires the application of complex steps to change provider attitudes, systemic accountability, policy implementation, and community empowerment. The next research that should be done is the effectiveness of interventions, as well as the inclusion of RMC indicators into national health systems.
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