Advancing Safe Motherhood in Sub-Saharan Africa: A Systematic Review of Community Knowledge, Attitudes, and Practices

Background Sub-Saharan Africa (SSA) bears a disproportionate burden of global maternal mortality, driven by preventable causes and barriers like poverty, low education, and cultural beliefs. Understanding community knowledge, attitudes, and practices (KAP) of safe motherhood is critical to improving maternal health outcomes. Objective This systematic review examines KAP regarding safe motherhood in SSA to identify barriers and inform interventions. Methods In accordance with PRISMA 2020 guidelines, a systematic search was conducted across PubMed, MEDLINE, EMBASE, CINAHL, Global Health, AJOL, and Scopus for peer-reviewed studies (2020–2025) on knowledge, attitudes, and practices (KAP) related to safe motherhood in Sub-Saharan Africa. After screening 2,500 records, eighteen studies were included. Study quality was assessed using the CASP and JBI checklists, and findings were synthesized narratively. Results Across 8 SSA countries, knowledge of maternal nutrition (45–70%), obstetric danger signs (20–45%), and unsafe abortion (20–50%) was low, except for family planning (70–95%). Practices lagged behind knowledge, with cultural taboos, poor healthcare experiences, and poverty limiting care-seeking. Education, urban residence, and media exposure improved KAP, while teens and rural women faced greater barriers. Conclusion Low KAP contributes to high maternal mortality in SSA. Community education, improved healthcare access, and targeted programs for teens are needed to advance maternal health. This review provides a foundation for developing context-specific interventions to meet Sustainable Development Goal 3.