Maternal mortality remains a significant challenge in sub-Saharan Africa, including in Eswatini. There is limited detailed research documenting the implementation and impact of innovative healthcare strategies within the specific context of the kingdom's maternal health services. This study aimed to identify, describe, and evaluate innovative strategies in maternal healthcare in Eswatini. Its objective was to assess the perceived effectiveness, challenges, and sustainability of these approaches from the perspective of healthcare providers and programme managers. A mixed-methods study was conducted. Data were collected via a review of programme documentation and in-depth, semi-structured interviews with a purposive sample of midwives, doctors, and health administrators involved in maternal care across all regions of Eswatini. Thematic analysis was used for qualitative data. Three dominant innovative themes were identified: task-shifting to nurse-midwives, community-based maternity waiting homes, and a mHealth appointment reminder system. The community-based waiting homes were perceived as the most effective, with interviewees reporting an associated increase in facility-based deliveries. Key challenges included resource limitations and staff training needs. Context-adapted strategies have been integrated into Eswatini's maternal healthcare system with perceived positive effects. Their success appears closely tied to community involvement and addressing systemic barriers to implementation. Sustainable funding for community-based initiatives should be prioritised. Further research is needed to quantify the clinical outcomes associated with these strategies. Policy should focus on scaling successful innovations while investing in continuous professional development for staff. maternal health, innovation, sub-Saharan Africa, Eswatini, healthcare delivery, midwifery This study provides a detailed evaluation of implemented maternal healthcare innovations in Eswatini, offering evidence to inform policy and practice for improving service delivery.
Mamba et al. (Fri,) studied this question.