{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:25:28Z","timestamp":1783398328604,"version":"3.54.6"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"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":["Sage Open Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The midwifery-led continuum of care model is an approach where a single midwife or a team of midwives provides comprehensive care to a woman throughout pregnancy, childbirth, and the early postpartum period. This model of care has significantly improved maternal and newborn outcomes; however, it is primarily implemented in high-income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the effect of the midwifery-led continuum of care model on maternal and neonatal health outcomes in general hospitals of the Sidama region in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective nonrandomized control trial was conducted from October 2023 to June 2024 in the Sidama region, Ethiopia. A systematic sampling technique was used to recruit 478 low-risk women in total for the intervention group and control group. Multivariable analysis for binary outcomes with the log link were conducted to estimate adjusted risk ratios Adjusted risk ratio (aRR) and 95% confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Women in the intervention were significantly more likely to have spontaneous vaginal birth (aRR) of 1.21 (95% confidence interval 1.14\u20131.67), and less likely to have preterm birth aRR of 0.16 (95% confidence interval 0.11\u20130.57) in comparison with women and newborns who received shared care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Women in the intervention group experience improved outcomes and seems to be a valuable strategy for improving pregnancy outcomes in low-resource settings. Further research should enhance the practical application of midwifery-led continuum of care for women facing social risk factors, and medical complications in low-resource settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>PACTR202310532830947<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Website:<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/pactr.samrc.ac.za\/\">https:\/\/pactr.samrc.ac.za\/<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20503121251383995","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T08:28:57Z","timestamp":1762331337000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The effect of midwifery-led continuum of care to improve maternal and newborn outcomes in the Sidama region, Ethiopia: A non-randomized control trial study"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1324-1631","authenticated-orcid":false,"given":"Rekiku","family":"Fikre","sequence":"first","affiliation":[{"name":"Department of Health Promotion, Faculty of Health, Medicine &amp; Life Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, The Netherlands"},{"name":"Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne","family":"Gerards","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Faculty of Health, Medicine &amp; Life Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wondwosen","family":"Teklesilasie","sequence":"additional","affiliation":[{"name":"School of Public Health, College of Medicine and Health Sciences, Hawassa University, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Gubbels","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Faculty of Health, Medicine &amp; Life Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Maternal mortality: levels and trends 2000\u20132020","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. Maternal mortality: levels and trends 2000\u20132020. World Health Organization, 2024."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep13030107"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2023-011911"},{"key":"e_1_3_3_5_2","volume-title":"Ethiopia Demographic and Health Survey 2016","author":"Central Statistical Agency (CSA) and ICF","year":"2016","unstructured":"Central Statistical Agency (CSA) and ICF. Ethiopia Demographic and Health Survey 2016. CSA and ICF, 2016."},{"key":"e_1_3_3_6_2","volume-title":"Ethiopia Mini Demographic and Health Survey 2019: final report","author":"Ethiopian Public Health Institute (EPHI) and ICF","year":"2021","unstructured":"Ethiopian Public Health Institute (EPHI) and ICF. Ethiopia Mini Demographic and Health Survey 2019: final report. EPHI and ICF, 2021."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1596\/978-1-4648-0348-2_ch1"},{"key":"e_1_3_3_8_2","volume-title":"Strengthening quality midwifery education for Universal Health Coverage 2030: framework for action","author":"World Health Organization (ed.)","year":"2019","unstructured":"World Health Organization (ed.) Strengthening quality midwifery education for Universal Health Coverage 2030: framework for action. World Health Organization, 2019."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30397-1"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1054\/midw.2001.0257"},{"issue":"4","key":"e_1_3_3_11_2","article-title":"Midwife-led continuity models versus other models of care for childbearing women","volume":"2016","author":"Sandall J","year":"2016","unstructured":"Sandall J, Soltani H, Gates S, et al. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev 2016; 2016(4): CD004667.","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"e_1_3_3_12_2","article-title":"Are midwife continuity of care models versus other models of care for childbearing women better for women and their babies?","volume":"2024","author":"Sandall J","year":"2024","unstructured":"Sandall J, Foureur M, Devane D, et al. Are midwife continuity of care models versus other models of care for childbearing women better for women and their babies? Cochrane Database Syst Rev 2024; 2024(4): CD004667.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12061"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-0944-6"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60790-X"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2021.08.008"},{"key":"e_1_3_3_17_2","article-title":"Perinatal outcomes of midwife-led care, stratified by medical risk: a retrospective cohort study from British Columbia (2008\u20132018)","volume":"195","author":"Stoll K","year":"2023","unstructured":"Stoll K, Turner M, Jones A, et al. Perinatal outcomes of midwife-led care, stratified by medical risk: a retrospective cohort study from British Columbia (2008\u20132018). Access Health Care 2023; 195: E292\u2013E299.","journal-title":"Access Health Care"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-05664-9"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0272110"},{"key":"e_1_3_3_20_2","volume-title":"Standards for improving quality of maternal and newborn care in health facilities","author":"World Health Organization","year":"2016","unstructured":"World Health Organization. Standards for improving quality of maternal and newborn care in health facilities. World Health Organization, 2016."},{"key":"e_1_3_3_21_2","volume-title":"Health facility and population profile","author":"Sidama Regional Health Bureau","year":"2021","unstructured":"Sidama Regional Health Bureau. Health facility and population profile. Sidama Regional Health Bureau, 2021."},{"key":"e_1_3_3_22_2","volume-title":"National Antenatal Care Guideline","author":"Federal Ministry of Health","year":"2022","unstructured":"Federal Ministry of Health. National Antenatal Care Guideline. Federal Ministry of Health, 2022."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"e_1_3_3_24_2","unstructured":"Sidama Regional Health Bureau. Health and Health Related Indicators. Hawassa Ethiopia 2022."},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_3_26_2","volume-title":"Basic Emergency Obstetric and Newborn Care (BEmONC) training manual","author":"Federal Democratic Republic of Ethiopia, Ministry of Health","year":"2018","unstructured":"Federal Democratic Republic of Ethiopia, Ministry of Health. Basic Emergency Obstetric and Newborn Care (BEmONC) training manual. Federal Ministry of Health, 2018."},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyac236"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06812-5"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-46"},{"issue":"3","key":"e_1_3_3_30_2","first-page":"2863","article-title":"Comparing the implications of midwifery-led care and standard model on maternal and neonatal outcomes during pregnancy, childbirth and postpartum","volume":"9","author":"Bagheri A","year":"2021","unstructured":"Bagheri A, Simbar M, Samimi M, et al. Comparing the implications of midwifery-led care and standard model on maternal and neonatal outcomes during pregnancy, childbirth and postpartum. J Midwifery Reprod Health 2021; 9(3): 2863\u20132872.","journal-title":"J Midwifery Reprod Health"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2016-000096"},{"key":"e_1_3_3_32_2","first-page":"41","article-title":"The midwifery-led care model: a continuity of care model in the birth path","volume":"90","author":"Ricchi A","year":"2019","unstructured":"Ricchi A, Rossi F, Borgognoni P, et al. The midwifery-led care model: a continuity of care model in the birth path. Acta Biomed 2019; 90(6-S): 41\u201352.","journal-title":"Acta Biomed"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536x.2000.00156.x"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.4274\/tjod.00087"},{"issue":"9","key":"e_1_3_3_35_2","first-page":"611","article-title":"The ethics of consent during labour and birth: episiotomies","volume":"49","author":"van der Pijl M","year":"2023","unstructured":"van der Pijl M, Verhoeven C, Hollander M, et al. The ethics of consent during labour and birth: episiotomies. BMJ Open 2023; 49(9): 611\u2013617.","journal-title":"BMJ Open"},{"key":"e_1_3_3_36_2","volume-title":"WHO recommendation on episiotomy policy","author":"World Health Organization","year":"2018","unstructured":"World Health Organization. WHO recommendation on episiotomy policy. World Health Organization; 2018."},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.14194\/ijmbr.1111"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2017.07.010"},{"key":"e_1_3_3_39_2","first-page":"233","article-title":"The effect of midwifery continuing care on childbirth outcomes","volume":"19","author":"Sehhatie F","year":"2014","unstructured":"Sehhatie F, Najjarzadeh M, Zamanzadeh V, et al. The effect of midwifery continuing care on childbirth outcomes. J Nurs Midwifery Res 2014; 19: 233\u2013237.","journal-title":"J Nurs Midwifery Res"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-11-85"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-030324"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12547"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2016.01.007"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0258248"}],"container-title":["Sage Open Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20503121251383995","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20503121251383995","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20503121251383995","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:31:14Z","timestamp":1777595474000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20503121251383995"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":43,"alternative-id":["10.1177\/20503121251383995"],"URL":"https:\/\/doi.org\/10.1177\/20503121251383995","relation":{},"ISSN":["2050-3121","2050-3121"],"issn-type":[{"value":"2050-3121","type":"print"},{"value":"2050-3121","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"article-number":"20503121251383995"}}