We conduct a literature review, systematically in line with the Pre-ferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.10 A computerized search was performed using Pubmed, Medline, Researchgate, Google Scholar, and the science web. Search studies were published between 2012 and 2019.

The process starts with the title and abstract filtering. Articles were independently reviewed based on inclusion criteria. Reference was found to the experiences of women, midwives, and service providers in the CoC model. The articles that were excluded were women with high-risk pregnancies and cesarean sections, the practice of the CoC model by midwifery students while studying at a midwifery academy, and issues of ethnicity, religion, race, and other conflict groups.

The literature was analyzed using a data extraction template. Templates are designed using keywords and scoring rubrics on relevant papers. Information extracted from each literature includes a country, objective, type of study, data collection, study sample size, and findings. Synthesis analyzes are presented and organized in an extraction table format (Table 1). Findings are presented in a narrative manner, taking into account each review question in order.

Covering 2804 articles were identified, 1170 abstract titles relevant to research objectives were screened. 114 articles were retrieved and reviewed based on inclusion and exclusion criteria and 16 articles were obtained descriptively (Fig. 1).

Fig. 1.

PRISMA flow diagram search and selection of studies.

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Summaries of 16 articles, five conducted in Australia, five in Africa, five in Asia, and one study from Sweden. Two qualitative design articles, one mixed method (Table 1), and 13 quantitative articles (Table 2).

Research location characteristics were collected from health facilities, communities, and states. There are 7 studies using DHS data, one online computer-based survey, and 8 questionnaires. Many quantitative methods are 12 cross-sectional studies, as well as one prospective cohort study. Most analysis tests use multivariate regression models and SEM 11 studies, followed by descriptive analysis. One study was conducted with a cohort design.11

All identified studies were midwifery care practices in antenatal (pregnancy), intranatal (childbirth), and postnatal (postpartum) care in hospitals, health centers, and even districts/states.12 Most of the studies describe complete socio-demographic characteristics. Two qualitative studies13,14 related to changes in management, organization, and changes in professionalism in the workplace of midwives, nurses, and doctors.

Meanwhile, the elements of hope and satisfaction of women, husbands, and families are emphasized. Another illustration, research in Australia, midwives, or nurses experience caseload, fatigue, psychological conditions, and open communication between them. Likewise in studies in Asia and Africa, coverage of the three service categories found the impact of CoC chain including its accompanying characteristics.

Three types of continuity are reviewed to see the part of the continuity setting based on the findings obtained in the CoC model practice. This finding refers to the concept of Haggerti et al. (2003) on Continuity of care: a multidisciplinary review.15

Continuity of information reported is an unsatisfactory response,16,17 the husband is confused where, to whom exactly complaints and questions are asked, less see the condition of mother,18,19 reliable source of information and education reliable source of information and education,13,20 unwanted pregnancy, future hopes for both parties, midwives always there, and on time.14 And, CoC perception is emphasized on caseload, burnout,18 and rather than general labor. However, on other hand, the workload is felt by midwives as being directly involved in a woman's real life.21 Most of the findings of maternal characteristics are demographic, socioeconomic, educational, and location distance,22–24 skills, resources: health facilities, medicines, standard procedures,23 delivery costs,17 information media, and transportation,19 traditional birth attendants in PNC.22

The practice of midwives in this finding revealed that women should understand how the practice of midwives worked during ANC to PNC, caseload with general care,21,24 family support, and joint decision making between women (mothers), families (husbands), and midwives. Newton et al. (2015)21 emphasize the uniqueness that first: work is a vocation that marginalizes personal needs, free time is provided, although burnout appears, at the same time must avoid boredom. Second: The notion of becoming a ‘real’ midwife. Psychological interaction between midwives and women has a comforting effect, that it turns out that in addition to a precious call also brings hope that they (midwives) become empathy, alert, and awake whenever needed, for the care process, given physical touch is also obtained psychological touch that affects effective communication and service satisfaction.23

This section focuses on how CoC is carried out and what are the results? The role of management, structural/organizational change, client, and service provider satisfaction. In line with the findings of some of these review studies, how important is access to coverage, the emergence of dropouts of services, their responsibilities and changing needs, service providers across programs, competence, and preparedness? In cases where this connection exists, concluded the importance of interprofessional collaboration and planning the right way and time.

Then, what is the scope of CoC and display out of service? Access to CoC coverage only increased antenatally, even among sub-Saharan Africa 4 low and 4 high from 12 states.7 Conversely, for less coverage, low in PNC and INC,6 and the lowest is ANC.12 Meanwhile, the output is lacking in three maternal care. For loss of CoC services, intranatal occurs,20 antenatal,11,17 appear in the intranatal half, and postnatal because of cost, rural and remote location, low education, and poor.6

In addition to drop out of service, another important aspect is the lack of ANC and PNC health facilities, authoritarian managers,23 Midwifery Group Practices mostly in urban hospitals.11 Professional satisfaction from the caseloads group, good interaction, reduced burnout, after a two-year trial from the baseline. Furthermore, qualitative studies, discussed management, the nursing process includes a philosophy: responsibility, being present on time, and effective communication. Example of a special faculty member interview “if we are going to reduce cesarean birth rates, midwives must always be accessible to pregnant women”. In home care management: high internal and external coordination, evaluation, program revision, and documentation increase. Therefore, the rights of recipients and health service providers are needed. Also, there is a neglect of professionalism ethics, commitment and human values, client rights and health provider rights,13 organizational changes, and future directions.14 That is the main interest of professionalism that should be avoided as a continuous violation. Professionalism also involves responsibility, accountability, autonomy, and legitimacy of the practice.21

Overall, the study shows that demographic characteristics, time, and place have an impact on each indicator of service coverage. Assessment of female characteristics is important as early recognition of risk factors and how the use of resources determines the priority of maternal best practice. In this regard, strategic efforts need to be strengthened at the micro-system level, and a holistic approach through socio-cultural, personal relationships between women and midwives, emotional, physical, and spiritual needs, in accordance with women's own expectations.25

Acknowledging the evidence of this CoC model, in Indonesia, it is both a challenge and an opportunity to achieve universal targets and reduce maternal mortality2 which is still the center of attention in Asian and African countries. Why is it important to study income differences and the similarities and geographic characteristics of different countries? Because responsive services can be provided to bridge the psychological needs of women and midwives or other related professions.26 Satisfaction and women's psychology as a measure of value and quality that must be presented and recognized.27,28

The barriers and facilitator elements play a role in determining the path between communication, two-way interaction, and management change. Therefore, detailed service findings vary in understanding patterns. One of the antenatal confounding factors is the case of unwanted pregnancy. For ANC, access is first made, and 42 days after delivery is the end of full service. INC was cut off due to constraints on the distance from the house to the facilities and assistance was not on time. For PNC, it is the highest mortality trend due to bleeding and eclampsia which is often ignored because it is considered a transitional period or rest at home so that these cultural and cultural factors also determine.29 Follow-up from 48h postpartum until menstruation is complete, accompanied by a traditional birth attendant (TBA). In line with qualitative research in Indonesia,30 the existence of TBA's in PNC is preferred by the community to midwives, therefore coverage is always low and services are interrupted between INC and PNC.