Health system barriers to effective implementation of maternal and child health programs

Despite substantial global investments, the implementation of maternal and child health (MCH) programs in low- and middle-income countries continues to be hindered by systemic health system barriers. This review synthesizes evidence from 18 peer-reviewed studies to identify eight major barriers: inadequate infrastructure, shortage of skilled health workforce, weak information systems, governance and policy failures, socio-cultural barriers, supply chain interruptions, poor community engagement, and insecurity in conflict zones. These challenges are interlinked, often compounding one another and leading to limited-service coverage, delayed care-seeking, and poor health outcomes. Strengthening infrastructure, investing in the health workforce, reforming governance, improving financing mechanisms, and promoting culturally sensitive community engagement are critical to achieving equitable and sustainable improvements in maternal and child health outcomes.