Quality of Maternal and Newborn Care in Humanitarian and Crisis Settings in Sub‐Saharan Africa: An Umbrella Review

Background and Aims

Humanitarian crises disrupt health systems, displace populations and limit access to essential services, threatening maternal and newborn survival in Sub Saharan Africa. Review level evidence on the quality of care in these settings is fragmented. This umbrella review aimed to synthesize evidence from systematic reviews on the quality of maternal and newborn care in humanitarian and crisis settings in Sub Saharan Africa, including dimensions of quality, barriers and facilitators, quality improvement strategies, and methodological gaps.

Methods

We searched nine databases and grey literature for reviews published from January 2015 to March 2026 (PROSPERO CRD420261396979; PRISMA 2020). Two reviewers independently screened records, extracted data and appraised methodological quality using AMSTAR 2. Overlap of primary studies was assessed with the corrected covered area. Findings were synthesized narratively by quality dimension. No meta‐analysis or hypothesis testing was performed.

Results

Of 1,284 records identified, 892 were screened after removing 392 duplicates, 74 full texts were assessed, and 12 records were included. AMSTAR 2 rated 4 of 12 as high quality, 6 moderate, 1 low and 1 critically low. Quality was compromised in effectiveness, safety, respectful care, equity, continuity and system readiness. Health system and supply barriers were reported in 8 of 12 records and insecurity related barriers in 7 of 12. Workforce training was the most frequent improvement strategy (6 of 12), mostly evaluated through process outcomes; evidence on mortality impact and long term neonatal outcomes was limited.

Conclusion

The quality of maternal and newborn care in humanitarian and crisis settings in sub‐Saharan Africa is compromised across multiple dimensions due to insecurity, displacement, workforce shortages, damaged infrastructure, and supply gaps. Context‐specific, respectful care and health system strengthening are needed, alongside improved evidence on neonatal care and long‐term outcomes.

PROSPERO Registration Number: CRD420261396979.