{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:59:39Z","timestamp":1790704779395,"version":"4.1.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>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\u2013Laird 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\u201381.67), followed by supportive care (62.59%; 95% CI: 59.44\u201365.73), and lowest for communication and autonomy (55.29%; 95% CI: 48.66\u201361.92), demonstrating significant gaps in provider\u2013patient communication and shared decision-making. Lower PCMC scores were associated with nighttime delivery (\u03b2\u2009= \u22122.23; 95% CI: \u22123.35, \u22121.11), third-trimester antenatal care initiation (\u03b2\u2009= \u22124.06; 95% CI: \u22127.74, \u22120.38), and rural residence (\u03b2\u2009= \u22121.61; 95% CI: \u22122.60, \u22120.61), 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).<\/jats:p>","DOI":"10.1371\/journal.pgph.0005909","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:28:21Z","timestamp":1790702901000},"page":"e0005909","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5627-8761","authenticated-orcid":true,"given":"Yaregal Admasu","family":"Alelign","sequence":"first","affiliation":[{"name":"Madda Walabu University","place":["Bale Robe, Ethiopia"],"department":["Department of Midwifery, College of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chernet","family":"Getnet","sequence":"additional","affiliation":[{"name":"Madda Walabu University","place":["Bale Robe, Ethiopia"],"department":["Department of Midwifery, College of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemitu","family":"Ayele","sequence":"additional","affiliation":[{"name":"Madda Walabu University","place":["Bale Robe, Ethiopia"],"department":["Department of Midwifery, College of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derese Eshetu","family":"Debela","sequence":"additional","affiliation":[{"name":"Madda Walabu University","place":["Bale Robe, Ethiopia"],"department":["Department of Midwifery, College of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Degefa","family":"Gomora","sequence":"additional","affiliation":[{"name":"Madda Walabu University","place":["Bale Robe, Ethiopia"],"department":["Department of Midwifery, College of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aynamaw","family":"Embiale","sequence":"additional","affiliation":[{"name":"Madda Walabu University","place":["Bale Robe, Ethiopia"],"department":["Department of Midwifery, College of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yordanos","family":"Sintayehu","sequence":"additional","affiliation":[{"name":"Madda Walabu University","place":["Bale Robe, Ethiopia"],"department":["Department of Biostatistics, School of Public Health, College of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neway","family":"Ejigu","sequence":"additional","affiliation":[{"name":"Madda Walabu University","place":["Bale Robe, Ethiopia"],"department":["Department of Midwifery, College of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"pgph.0005909.ref001","unstructured":"Group WB. Trends in maternal mortality estimates 2000 to 2023. 2023."},{"issue":"6","key":"pgph.0005909.ref002","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001847","article-title":"The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review","volume":"12","author":"MA Bohren","year":"2015","journal-title":"PLoS Med"},{"key":"pgph.0005909.ref003","volume-title":"Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA\/Population Division","author":"Organization WH","year":"2023"},{"issue":"1","key":"pgph.0005909.ref004","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1186\/s12913-018-3183-x","article-title":"Predictors of person-centered maternity care: The role of socioeconomic status, empowerment, and facility type","volume":"18","author":"PA Afulani","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"pgph.0005909.ref005","article-title":"Exploring evidence for disrespect and abuse in facility-based childbirth: Report of a landscape analysis","author":"D Bowser","year":"2010","journal-title":"USAID-Traction Proj"},{"key":"pgph.0005909.ref006","author":"SG Gebremichael","year":"2021","journal-title":"Determinants of institutional delivery in Sub-Saharan Africa: Findings from Demographic and Health Survey (2013 \u2013 2017) from nine countries"},{"issue":"1","key":"pgph.0005909.ref007","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1186\/s12978-017-0381-7","article-title":"Development of a tool to measure person-centered maternity care in developing settings: Validation in a rural and urban Kenyan population","volume":"14","author":"PA Afulani","year":"2017","journal-title":"Reprod Health"},{"issue":"8","key":"pgph.0005909.ref008","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1111\/1471-0528.13451","article-title":"Quality of care for pregnant women and newborns-the WHO vision","volume":"122","author":"\u04e6 Tun\u00e7alp","year":"2015","journal-title":"BJOG"},{"key":"pgph.0005909.ref009","unstructured":"Organization WH. Standards for improving quality of maternal and newborn care in health facilities. 2016;."},{"key":"pgph.0005909.ref010","doi-asserted-by":"crossref","first-page":"20503121231225350","DOI":"10.1177\/20503121231225352","article-title":"Person-centered maternity care during childbirth and associated factors among mothers who gave birth at public health institutions of Debre Markos town, Northwest Ethiopia, 2022: A cross-sectional study","volume":"12","author":"YA Alelign","year":"2024","journal-title":"SAGE Open Med"},{"issue":"1","key":"pgph.0005909.ref011","article-title":"Disrespectful and abusive treatment during facility delivery in Tanzania: A facility and community survey","volume":"33","author":"ME Kruk","year":"2018","journal-title":"Health Policy Plan"},{"issue":"10056","key":"pgph.0005909.ref012","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1016\/S0140-6736(16)31472-6","article-title":"Beyond too little, too late and too much, too soon: A pathway towards evidence-based, respectful maternity care worldwide","volume":"388","author":"S Miller","year":"2016","journal-title":"Lancet"},{"issue":"1","key":"pgph.0005909.ref013","doi-asserted-by":"crossref","first-page":"100140","DOI":"10.1016\/j.xagr.2022.100140","article-title":"Understanding variation in person-centered maternity care: Results from a household survey of postpartum women in 6 regions of Ethiopia","volume":"3","author":"EK Stierman","year":"2022","journal-title":"AJOG Glob Rep"},{"issue":"3","key":"pgph.0005909.ref014","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2024-017337","article-title":"Levels and determinants of person-centred maternity care among women living in urban informal settlements: Evidence from client exit surveys in Nairobi, Lusaka and Ouagadougou","volume":"10","author":"SS Jiwani","year":"2025","journal-title":"BMJ Glob Health"},{"key":"pgph.0005909.ref015","doi-asserted-by":"crossref","first-page":"20503121241257790","DOI":"10.1177\/20503121241257790","article-title":"Person-centered maternity care during childbirth and associated factors at public hospitals in central Ethiopia","volume":"12","author":"WD Kabale","year":"2024","journal-title":"SAGE Open Med"},{"issue":"1","key":"pgph.0005909.ref016","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1186\/s12884-022-04909-3","article-title":"Person-centered care during childbirth and associated factors among mothers who gave birth at health facilities in Hawassa city administration Sidama Region, Southern Ethiopia","volume":"22","author":"SA Getahun","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pgph.0005909.ref017","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1186\/s12884-020-03221-2","article-title":"Determinants of person-centered maternity care at the selected health facilities of Dessie town, Northeastern, Ethiopia: community-based cross-sectional study","volume":"20","author":"FT Dagnaw","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pgph.0005909.ref018","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/s12978-022-01503-w","article-title":"Person-centered maternity care during childbirth and associated factors at selected public hospitals in Addis Ababa, Ethiopia, 2021: A cross-sectional study","volume":"19","author":"AA Tarekegne","year":"2022","journal-title":"Reprod Health"},{"key":"pgph.0005909.ref019","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"MJ Page","year":"2021","journal-title":"BMJ"},{"key":"pgph.0005909.ref020","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/978-94-007-3024-3_10","article-title":"Meta-analysis of observational studies","author":"DC Greenwood","year":"2012","journal-title":"Modern methods for epidemiology. Springer Netherlands"},{"key":"pgph.0005909.ref021","unstructured":"JBI Global. 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Stierman","year":"2022"},{"issue":"4","key":"pgph.0005909.ref029","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1111\/hex.13781","article-title":"Person-centred sexual and reproductive health: A call for standardized measurement","volume":"26","author":"PA Afulani","year":"2023","journal-title":"Health Expect"},{"issue":"1","key":"pgph.0005909.ref030","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s12939-019-0980-8","article-title":"Providers and women\u2019s perspectives on person-centered maternity care: A mixed methods study in Kenya","volume":"18","author":"M Sudhinaraset","year":"2019","journal-title":"Int J Equity Health"},{"issue":"1","key":"pgph.0005909.ref031","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/ijgo.12978","article-title":"Association between person-centered maternity care and newborn complications in Kenya","volume":"148","author":"M Sudhinaraset","year":"2020","journal-title":"Int J Gynaecol 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and examining suicidal methods distribution","volume":"7","author":"J Kanani","year":"2024","journal-title":"Brain Behavior and Immunity Integrative"},{"key":"pgph.0005909.ref047","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/ijph.2021.612894","article-title":"Perception of person-centred maternity care and its associated factors among post-partum women: Evidence from a cross-sectional study in Enugu State, Nigeria","volume":"66","author":"DC Ogbuabor","year":"2021","journal-title":"Int J Public Health"},{"issue":"1","key":"pgph.0005909.ref048","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12978-016-0270-5","article-title":"Maternal health care service seeking behaviors and associated factors among women in rural Haramaya District, Eastern Ethiopia: A triangulated community-based cross-sectional study","volume":"14","author":"D Kifle","year":"2017","journal-title":"Reprod 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