Published in PLOS One on 2026-06-03, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Tolera Gudissa Damme, Sileshi Garoma Abeya, Dereje Bayissa Demissie
Source: PLOS One • DOI 10.1371/journal.pone.0350555
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Evidence shows that health care delivery is inadequate and poor quality in low- and middle-income countries. Recently, poor quality of health care has been a more significant challenge for reducing maternal and perinatal mortality than insufficient access to health care services. However, data on barriers and facilitators to quality emergency obstetric and newborn care service in Ethiopia are limited. Therefore, this study aims to explore the perceptions and experiences of women and providers on barriers and facilitators of quality emergency obstetric and newborn care services in public hospitals of West Shoa Zone, Ethiopia.
A phenomenological qualitative study was conducted in four selected public hospitals of West Shoa Zone from June 01 to July 30 of 2024. A total of sixty-five study participants were purposively selected and interviewed until data saturation. The data were collected through focus group discussions (38 participants), in-depth interviews (12 participants), and key informant interviews (15 participants). The collected data were transcribed verbatim and translated into English language. Finally, MAXQDA software version 24.4.1 was used for thematic data analysis.
The study findings were categorized into two major themes (i.e., barriers and facilitators) and three sub-themes (factors related to health care facilities, factors related to health care providers, and factors related to clients and the community as a whole). The main identified barriers were a shortage of medical resources and facility infrastructures; insufficient human resources; knowledge and skill gaps of health care providers; inadequate respectful maternity care; a weak client referral system; a lack of updated training; limited community awareness on emergency cases; and inadequate mentoring and supervision activities. In contrast, the major facilitators included the availability of free maternity services, a multidisciplinary team, strong provider commitment and teamwork, establishment of neonatal intensive care units and blood banks, access to ambulances, and community pharmacies.
This study identified a range of barriers and facilitators influencing the quality of emergency obstetric and newborn care services, encompassing factors related to healthcare facilities, healthcare providers, as well as clients and the whole community. Therefore, all health care facilities and the regional health bureau need to improve the identified barriers and strengthen all facilitators of quality emergency obstetric and newborn care services.
Introduction
Obstetric emergencies are health problems that are life-threatening for both pregnant women and their newborn babies. They require prompt and focused interventions to save the lives of the mother and/or her babies [1]. Globally, about 260, 000 women died during and following pregnancy and childbirth in 2023, equivalent to over 700 maternal deaths every day, and approximately one every two minutes. Approximately 92% of all maternal deaths occurred in low- and lower-middle-income countries. Sub-Saharan Africa alone accounted for around 70% of maternal deaths (182,000), while southern Asia accounted for around 17% (43,000) [2]. According to preliminary findings from the Ethiopia Demographic and Health Survey (EDHS) of 2024–2025, the the maternal mortality ratio was 141 deaths per 100,000 live births, and the neonatal mortality rate was 25 deaths per 1000 live births [3].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Tolera Gudissa Damme, Sileshi Garoma Abeya, Dereje Bayissa Demissie. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Preconception care services in Northern Ethiopia: A qualitative exploration of awareness, experiences, challenges, opportunities, and prospects
- Evidence brief: Health system responsiveness and its associated factors for delivery care in public health facilities of West Arsi Zone, Oromia, Ethiopia
- Evidence brief: Companionship utilization and its associated factors during childbirth among mothers who delivered at public hospitals in Shashemene town, Southern Ethiopia: A mixed-method study
