Maternal health outcomes in sub-Saharan Africa require sustained improvement. Although community engagement is promoted to enhance service delivery, empirical evidence on transferring community-based medicine models between different African regions is limited. This study evaluated the implementation and perceived impact of adapting a West African community-based medicine model to Zimbabwe's context. The primary objective was to identify key facilitators and barriers to local engagement in maternal health initiatives during this adaptation. A qualitative, exploratory case study was conducted in two rural Zimbabwean districts. Data were collected through focus group discussions with community health workers and mothers, and semi-structured interviews with traditional leaders, midwives, and district health officials. Thematic analysis was employed. The adapted model strengthened trust between the formal health sector and communities. Integrating respected community elders into leadership was a critical facilitator, enhancing programme acceptance. Key barriers included entrenched traditional beliefs that sometimes conflicted with biomedical advice, and persistent resource limitations. The West African model showed potential for improving community engagement in Zimbabwean maternal health initiatives. Success depended on deep contextual adaptation rather than direct replication, with collaborative governance involving existing community leadership being essential. Policymakers should prioritise co-designing maternal health programmes with local community structures. Initiatives must allocate resources for sustained dialogue to address cultural sensitivities. Further research should quantify the impact on specific maternal health indicators. community engagement, maternal health, Zimbabwe, West Africa, health systems, qualitative research, traditional leadership This research provides evidence on the cross-regional application of community-based health models in Africa, offering practical insights for policymakers designing adapted maternal health initiatives.
Moyo et al. (Mon,) studied this question.