Humanising childbirth: Evaluation of maternity acupressure training for healthcare providers at Edna Adan University and Hospital in Hargeisa, Somaliland, Africa.

BACKGROUND: Humanised, respectful maternity care improves birth outcomes, enhances maternal satisfaction, and reduces the risk of trauma and unnecessary intervention. Integrative maternity care-incorporating evidence-based traditional, complementary and integrative medicines (TCIM) such as acupressure and massage-can support this approach. However, an evidence-practice gap remains, particularly in low- and middle-income countries (LMICs), where integrative modalities are rarely incorporated into provider education or evaluated for contextual appropriateness. AIM: To evaluate the implementation, acceptability and feasibility of an 'Acupressure for childbirth' training program at Edna Adan Hospital in Somaliland, Africa; and determine conditions for which these techniques were most useful. METHODS: Participants completed training and evaluation of skills, and provided responses to surveys pre-training, immediately post-training, and six-months post-training. RESULTS: The 56 participants included midwives, nurses, doulas, students, educators and physicians. Significant improvements in knowledge and skills were observed post-training (p < 0.01) and sustained at six-months (p < 0.05). Participants reported high satisfaction and regular clinical use, most commonly for labour preparation and pain management. In a context of high prevalence of female genital mutilation (FGM), participants reported particular benefit for heightened anxiety, fear and pain, noting increased comfort, relaxation and emotional reassurance during labour. Techniques were observed as easy to integrate into routine care and positively received by women and support people. CONCLUSION: This evaluation demonstrates that maternity care provider training in acupressure and massage is feasible, acceptable and appropriate within a low-resource maternity setting. Integrative, non-invasive techniques may provide valuable physical and psychosocial support, highlighting the importance of contextual fit and strengthening humanised maternity care.