{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T02:20:35Z","timestamp":1785810035842,"version":"3.56.0"},"reference-count":103,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Disrespectful care violates women\u2019s rights, delays care-seeking and contributes to preventable adverse birth outcomes. Although Respectful Maternity Care (RMC) is a key strategy for improving maternal and neonatal health, evidence on factors affecting its implementation in least-developed countries remains poorly synthesised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the barriers and facilitators of RMC in low-income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review synthesising evidence from qualitative and mixed-methods studies was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources and methods<\/jats:title>\n                    <jats:p>A systematic search was conducted across major databases, including Scopus, Web of Science, PubMed, CINAHL, and Embase. Eligibility criteria were defined using the SPIDER framework. Studies published between 2015 and 2025 were included. Methodological quality was assessed using JBI SUMARI for qualitative studies and the QATSDD tool for mixed-methods studies. SPIDER framework was applied to support eligibility criteria. The review followed PRISMA guidelines. The data were synthesised using thematic analysis and applied to the Socio-Ecological Model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-eight studies conducted in least-developed countries were analysed, consisting of 36 qualitative studies and 12 mixed-methods studies. Barriers and facilitators to RMC were identified at individual (knowledge, attitude, skills), interpersonal, organizational (resources, infrastructures), policy (guidelines, education), and socio-cultural level (norms, cultures).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Strengthening RMC is crucial for reducing maternal and neonatal mortality. The review highlights the need for supportive policies, improved infrastructure, and targeted provider training. Future research should develop and validate context-specific RMC principles and indicators to strengthen providers\u2019 understanding and skills for practice in least-developed countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>The protocol was registered with PROSPERO (CRD42023443998).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057261450176","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T19:30:21Z","timestamp":1781724621000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Overcoming barriers and harnessing facilitators: Respectful maternity care in least-developed countries - a systematic review"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3448-8310","authenticated-orcid":false,"given":"Ephrem","family":"Yohannes","sequence":"first","affiliation":[{"name":"Ambo University"},{"name":"Griffith University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8889-201X","authenticated-orcid":false,"given":"Gonfa","family":"Moti","sequence":"additional","affiliation":[{"name":"Ambo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4662-9125","authenticated-orcid":false,"given":"Eshetu E.","family":"Chaka","sequence":"additional","affiliation":[{"name":"Ambo University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1967-1712","authenticated-orcid":false,"given":"Laura","family":"Gabriel","sequence":"additional","affiliation":[{"name":"University of Sunshine Coast"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3046-4143","authenticated-orcid":false,"given":"Debra K.","family":"Creedy","sequence":"additional","affiliation":[{"name":"Griffith University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2007-0543","authenticated-orcid":false,"given":"Carolyn","family":"Hastie","sequence":"additional","affiliation":[{"name":"Griffith University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_3_7_2_2","unstructured":"World Health Organization. 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