Document resource
Background Community-based maternity care has the potential to improve access, equity, and service quality, particularly for underserved populations. This rapid review aimed to explore the feasibility and acceptability of community-based maternity care among service users and providers; and key barriers and facilitators to implementation.Methods Cochrane Rapid Review methods were followed and reported in line with the PRISMA 2020 guidelines. The review protocol was registered on PROSPERO. Eligible studies published since 2015 focused on community-based maternity services and reported feasibility, acceptability, implementation and maternal health outcomes. Searches of MEDLINE, PsycINFO, MIDIRS, and grey literature were conducted in June 2025. Data were extracted across seven domains; acceptability, service-user satisfaction, barriers, facilitators, maternal health outcomes, equity and sustainability; and synthesised narratively. Two reviewers independently assessed study quality using the National Institute for Health and Care Excellence (NICE) checklist for qualitative studies, with inter-rater reliability of 0.7 (Cohen’s kappa).Results Ten studies met inclusion criteria (n=8 qualitative; n=2 cross-sectional) from low- (n=4), middle- (n=3), and high-income (n=3) countries. Sample sizes ranged from 24 to 312. Most studies (n=7) focused on service users; three included providers including midwives, health workers, and birth attendants. Interventions included community midwifery, home visits, mobile clinics, and culturally tailored models. Acceptability was high when integrated into existing systems and aligned with sociocultural norms. Facilitators included trusted providers, community engagement, supervision, and policy integration. Barriers included limited transport, inadequate staffing, gender-based power imbalances affecting care-seeking behaviours, and weak referral pathways. Health outcomes included improved antenatal attendance, skilled birth uptake, and maternal health knowledge.Conclusion Community-based maternity care is feasible and acceptable when contextually adapted and supported by local systems. Sustainability requires workforce investment, supervision, and policy integration. Future research should assess cost-effectiveness, long-term outcomes, and experiences of providers and service users.