Integrating Sustainable Development and Maternal Healthcare: A Mixed Methods Study of Ugandan Practices and Perspectives

Integrating sustainable development principles into maternal healthcare is a persistent challenge in low-resource settings. In Uganda, where maternal mortality remains high, aligning healthcare delivery with sustainability is crucial for long-term health system resilience. This study aimed to explore the integration of sustainable development within Ugandan maternal healthcare. Its objectives were to describe current practices, identify barriers and facilitators, and understand stakeholder perspectives on sustainable service delivery. A convergent parallel mixed methods design was employed. Quantitative data came from a retrospective analysis of health facility records. Qualitative data were gathered through semi-structured interviews and focus group discussions with healthcare providers, policymakers, and service users across four districts. Thematic analysis and descriptive statistics were used. Quantitative data indicated that 68% of facilities experienced stock-outs of essential medicines at least quarterly. Qualitative analysis identified a central theme of ‘pragmatic adaptation’, where providers improvised solutions amid resource constraints. This often compromised standardised care and environmental waste management. Current maternal healthcare practices in Uganda demonstrate ad-hoc resilience but operate without a systematic framework for integrating sustainable development. This gap contributes to service inconsistency and may exacerbate long-term system vulnerabilities. Develop and pilot a context-specific sustainability framework for maternal health clinics. Strengthen supply chain logistics to reduce stock-outs. Integrate training on sustainable clinical practices and waste management into continuing professional development. Sustainable development, maternal health, mixed methods, Uganda, healthcare systems, resource-limited settings This study provides an integrated analysis of quantitative service delivery data and qualitative stakeholder insights, offering an evidence base for designing sustainable maternal healthcare interventions in Uganda and similar contexts.