Publications by authors named "Shree Mandke"

Article Synopsis
  • The text discusses how Midwife-led birth centres (MLBCs) offer a viable alternative to traditional hospital care for low-risk pregnancies, aiming to improve maternal and neonatal health outcomes.
  • A cost analysis of 12 MLBC sites in Bangladesh, Pakistan, and Uganda revealed significant variability in costs per birth, highlighting midwife salaries and operational expenses as key factors.
  • The findings suggest that MLBCs can lead to better health outcomes at lower costs or provide high cost-effectiveness compared to standard care, indicating the need for further cost assessments during implementation.
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Background: Midwives are essential providers of primary health care and can play a major role in the provision of health care that can save lives and improve sexual, reproductive, maternal, newborn and adolescent health outcomes. One way for midwives to deliver care is through midwife-led birth centres (MLBCs). Most of the evidence on MLBCs is from high-income countries but the opportunity for impact of MLBCs in low- and middle-income countries (LMICs) could be significant as this is where most maternal and newborn deaths occur.

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The evidence for the benefits of midwifery has grown over the past two decades and midwife-led birthing centres have been established in many countries. Midwife-led care can only make a sustained and large-scale contribution to improved maternal and newborn health outcomes if it is an integral part of the health care system but there are challenges to the establishment and operation of midwife-led birthing centres. A network of care (NOC) is a way of understanding the connections within a catchment area or region to ensure that service provision is effective and efficient.

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Evidence about the safety and benefits of midwife-led care during childbirth has led to midwife-led settings being recommended for women with uncomplicated pregnancies. However, most of the research on this topic comes from high-income countries. Relatively little is known about the availability and characteristics of midwife-led birthing centres in low- and middle-income countries (LMICs).

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