Effectiveness of Community-Based Health Education Interventions on Maternal Health Service Uptake in Sub-Saharan Africa: A Systematic Review

Abstract

Background: Maternal mortality and low utilization of essential maternal health services remain major public health challenges across Sub-Saharan Africa. Poor awareness, sociocultural barriers, low health literacy, and weak community engagement continue to limit the use of antenatal, delivery, and postnatal services. Community-based health education interventions have been introduced to improve knowledge and healthcare seeking behavior, but evidence on their effectiveness remains fragmented.. Methods: A structured search of PubMed, Scopus, Web of Science, ScienceDirect, and AJOL was conducted for studies published between 2010 and 2026. Eligible studies assessed community-based educational approaches such as home visits, women’s groups, peer education, and outreach campaigns designed to increase maternal health service use. PRISMA guidelines informed study selection, while quality appraisal used the Joanna Briggs Institute checklist. Results: A total of 30 studies from multiple countries in Sub-Saharan Africa met inclusion criteria. Antenatal care attendance increased by 18% - 47% across intervention settings, while skilled birth attendance improved by 12% - 39%. Facility-based delivery rose by 15% - 42%, and postnatal care attendance increased by 10% - 34%. Interventions involving community health workers, male partners, and local leaders produced stronger outcomes than facility-only education models. Rural residence, low literacy, and weak referral systems reduced intervention effectiveness. Conclusion: Community-based health education interventions significantly improve maternal health service uptake in Sub-Saharan Africa. Scaling culturally appropriate community strategies can enhance service utilization and reduce preventable maternal deaths.