Respectful maternity care in low- and middle-income countries: a narrative review of evidence, implementation challenges, and future directions

Respectful maternity care (RMC) is increasingly recognized as a fundamental component of quality maternal healthcare and a basic human right. Despite global efforts to maximize facility-based deliveries, widespread institutional mistreatment, abuse, and neglect continue to compromise maternal safety and undermine public trust in healthcare systems. This narrative review offers a timely, comprehensive synthesis of evidence from low- and middle-income countries (LMICs) between 2015 and 2026. It provides a critical assessment of the multi-level architecture shaping RMC by mapping how individual provider behaviors, facility infrastructure, systemic health policies, and deep-seated socio-cultural norms intersect to influence childbirth experiences.