A Meta-Analysis of Obstetric and Gynaecological Healthcare Challenges in Seychelles: An African Perspective from 2000 to 2026

Seychelles, as a small island developing state, faces distinct challenges in delivering obstetric and gynaecological healthcare. A consolidated evidence base regarding these specific barriers is required to inform effective policy within an African island context. This meta-analysis aimed to synthesise existing evidence on the key challenges affecting obstetric and gynaecological healthcare services in Seychelles, providing a consolidated perspective to guide future interventions. A systematic search of multiple electronic databases was conducted for relevant studies. Inclusion criteria encompassed qualitative, quantitative, and mixed-methods studies focusing on service delivery, access, or outcomes in Seychelles. Data were extracted and analysed using thematic synthesis for qualitative data and random-effects meta-analysis for quantitative data where possible. The analysis identified several persistent, interconnected challenges. A prominent theme was geographical inequity in access to specialist care, which disproportionately affected populations on outer islands. Workforce shortages, particularly in midwifery and specialist obstetrics, were also a consistently reported barrier across the included studies. Obstetric and gynaecological healthcare in Seychelles is constrained by systemic issues related to its island geography and resource limitations. These challenges are complex and mutually reinforcing, necessitating context-specific strategies to improve health outcomes and equity. Key recommendations include prioritising the strengthening of telehealth services to bridge geographical gaps, investing in specialised training and retention programmes for the local healthcare workforce, and developing integrated care pathways that address both clinical and logistical barriers to access. Seychelles, maternal health, gynaecology, healthcare access, meta-analysis, African health systems, island health This study provides a consolidated, evidence-based overview of obstetric and gynaecological healthcare challenges in Seychelles, offering a focused analysis for regional policymakers and clinicians within the African context.