Maternal mortality persists as a major public health issue in sub-Saharan Africa. Community-led health initiatives are advocated to improve maternal care, but structured evidence on their implementation and effectiveness in specific national contexts is limited. This protocol describes a study to investigate a West African model of community engagement for potential adaptation in Eswatini. The purpose is to develop a contextually appropriate framework for community-led maternal health initiatives in Eswatini, informed by West African experiences. The objectives are to: 1) analyse the key components and implementation processes of selected West African community-led maternal care initiatives; 2) assess the feasibility and acceptability of adapting these components within Eswatini's health system and cultural context; and 3) co-design a prototype implementation model with stakeholders in Eswatini. This multi-phase qualitative study will comprise three phases. Phase one entails a desk-based documentary review and analysis of documented West African initiatives. Phase two will use key informant interviews and focus group discussions with community health workers, traditional birth attendants, healthcare professionals, and mothers in Eswatini to explore adaptation feasibility. Phase three will involve participatory workshops with stakeholders to co-design the prototype model. This is a protocol for proposed research; no empirical findings are presented. The anticipated output is a detailed, co-designed prototype model for pilot testing, expected to identify transferable components such as specific community health worker roles or community support mechanisms. The study is expected to yield a tailored, evidence-informed framework for community-led maternal health initiatives in Eswatini, derived from relevant West African experiences, thereby addressing a gap in context-specific implementation guidance. Subsequent research should focus on piloting and rigorously evaluating the co-designed model. Policymakers should consider the findings for integrating effective community-led strategies into national maternal health policy. maternal health, community participation, health services research, implementation science, Eswatini, West Africa, protocol. This protocol outlines a structured approach to generate evidence for adapting a community-led health initiative from one sub-Saharan African region to another, with potential to inform policy and practice in similar settings.
Dlamini et al. (Fri,) studied this question.