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Individual, health facility and wider health system factors contributing to maternal deaths in Africa

A scoping review

Bibliographic Data

ID19591506
AuthorsFrancis G Muriithi (0000-0002-2314-5611, University of Birmingham, corresponding author), Aduragbemi Banke-Thomas (0000-0002-4449-0131, University of Greenwich), Ruth W Gakuo (0000-0003-4658-8949, University of Derby), Kia Pope (0000-0003-0493-1040, Queen's Medical Centre), Arri Coomarasamy (0000-0002-3261-9807, University of Birmingham), Ioannis D Gallos (0000-0002-2766-358X, University of Birmingham)
EditorsHannah Hogan Leslie
Year2022
Volume2
Issue7
Pagese0000385
Publication date2022-07-20
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000385
PMID36962364
OpenAlexW4286007853
LanguageEN
Citations received7
References cited98

The number of women dying during pregnancy and after childbirth remains unacceptably high, with African countries showing the slowest decline. The leading causes of maternal deaths in Africa are preventable direct obstetric causes such as haemorrhage, infection, hypertension, unsafe abortion, and obstructed labour. There is an information gap on factors contributing to maternal deaths in Africa. Our objective was to identify these contributing factors and assess the frequency of their reporting in published literature. We followed the Arksey and O’Malley methodological framework for scoping reviews. We searched six electronic bibliographic databases: MEDLINE, SCOPUS, African Index Medicus, African Journals Online (AJOL), French humanities and social sciences databases, and Web of Science. We included articles published between 1987 and 2021 without language restriction. Our conceptual framework was informed by a combination of the socio-ecological model, the three delays conceptual framework for analysing the determinants of maternal mortality and the signal functions of emergency obstetric care. We included 104 articles from 27 African countries. The most frequently reported contributory factors by level were: (1) Individual—level: Delay in deciding to seek help and in recognition of danger signs (37.5% of articles), (2) Health facility—level: Suboptimal service delivery relating to triage, monitoring, and referral (80.8% of articles) and (3) Wider health system—level: Transport to and between health facilities (84.6% of articles). Our findings indicate that health facility—level factors were the most frequently reported contributing factors to maternal deaths in Africa. There is a lack of data from some African countries, especially those countries with armed conflict currently or in the recent past. Information gaps exist in the following areas: Statistical significance of each contributing factor and whether contributing factors alone adequately explain the variations in maternal mortality ratios (MMR) seen between countries and at sub-national levels

Abortion · Childbirth · Environmental health · Family medicine · Health care · Health facility · Health services · Maternal death · Maternal health · Medical emergency · MEDLINE · Obstetric transition · Political science · Population · Pregnancy · Referral · Scopus · Triage · Global Maternal and Child Health · Maternal and fetal healthcare · Maternal and Perinatal Health Interventions · Medicine

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    Open Access•Hodan A Duale, Abdiqani Ahmed Farah et al.•Frontiers in Public Health•2023

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    Open Access•Manuela Straneo, Lenka Beňová et al.•International Journal for Equity…•2025

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    Open Access•Brittney van de Water, Ashley H Longacre et al.•PLOS Global Public Health•2026

  • Reporting maternal deaths in Anglophone West Africa

    Open Access•Kiran Roy, Noimot Balogun et al.•PLOS Global Public Health•2026

  • A systematic review of behaviour change interventions to improve maternal health outcomes in sub-Saharan Africa

    Open Access•Francis G Muriithi, Aduragbemi Banke-Thomas et al.•PLOS Global Public Health•2024

  • Identifying delays impacting maternal and perinatal deaths using a facility-based death audit review system integrated with community engagement

    Open Access•Zahid Memon, Wardah Ahmed et al.•Journal of Global Health•2026

  • Global causes of maternal death

    Open Access•Lale Say, Doris Chou et al.•The Lancet Global Health•2014

  • Global, regional, and national levels of maternal mortality, 1990–2015

    Open Access•Nicholas J Kassebaum, Ryan M Barber et al.•The Lancet•2016

  • Strategies for reducing maternal mortality

    Open Access•Oona M R Campbell, Oona MR Campbell et al.•The Lancet•2006

  • Updated methodological guidance for the conduct of scoping reviews

    Micah D J Peters, Casey Marnie et al.•JBI Evidence Synthesis•2020

  • Disparities in pregnancy-related deaths

    Open Access•Sanni Yaya, Seun Anjorin et al.•BMJ Global Health•2021

  • A framework for identifying and learning from countries that demonstrated exemplary performance in improving health outcomes and systems

    Open Access•Austin Carter, Kohn Pedersen et al.•BMJ Global Health•2020

  • Discrepancies between national maternal mortality data and international estimates

    Glen Mola, Manuel Sánchez Alonso et al.•Reproductive Health Matters•2013

  • Can innovative ambulance transport avert pregnancy–related deaths? One–year operational assessment in Ethiopia

    Open Access•Hagos Godefay, John Kinsman et al.•Journal of Global Health•2016

  • Gewalt gegen Frauen

    Open Access•Grit Höppner•Soziale Passagen•2023

  • Causes and contributing factors of maternal mortality in Bosaso District of Somalia. A retrospective study of 30 cases using a Verbal Autopsy approach

    Open Access•Jamila Ahmed Aden, Hinda Jama Ahmed et al.•Global Health Action•2019

  • Risk factors for maternal death in the highlands of rural northern Tanzania

    Open Access•Bjørg Evjen-Olsen, Bjørg Evjen‐olsen et al.•BMC Public Health•2008

  • Factors associated with maternal mortality in Sub-Saharan Africa

    Open Access•Josè Luis Alvarez, José Luis Álvarez Macías et al.•BMC Public Health•2009

  • Human immunodeficiency virus and Aids and other important predictors of maternal mortality in Mulago Hospital Complex Kampala Uganda

    Open Access•Julius Wandabwa, Julius N Wandabwa et al.•BMC Public Health•2011

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    Open Access•Eugene J Kongnyuy, Grace Mlava et al.•Women s Health Issues•2008

  • Violence Against Women

    Open Access•Lori Heise, Lori L Heise•Violence Against Women•1998

  • Operational Factors Affecting Maternal Mortality in Tanzania

    Open Access•Ernest Urassa, S Massawe et al.•Health Policy and Planning•1997

  • A Framework for Analyzing the Determinants of Maternal Mortality

    James Mccarthy, Deborah Maine•Studies in Family Planning•1992

  • A Community-based Investigation of Avoidable Factors for Maternal Mortality in Zimbabwe

    Susan Fawcus, M T Mbizvo et al.•Studies in Family Planning•1996

  • What explains sub-national variation in maternal mortality rates within developing countries? A political economy explanation

    Open Access•Badru Bukenya, Frederick Golooba-Mutebi•Social Science & Medicine•2020

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    Hilary Arksey, Lisa O’malley•International Journal of Social…•2005

  • Maternal mortality in rural and urban Zimbabwe

    Open Access•M T Mbizvo, Susan Fawcu et al.•Social Science & Medicine•1993

  • Too far to walk

    Open Access•Sereen Thaddeu, Sereen Thaddeus et al.•Social Science & Medicine•1994

  • Political contexts and maternal health policy

    Open Access•Stephanie L Smith•Social Science & Medicine•2014

  • Armed conflict and maternal mortality

    Open Access•A Kotsadam, Gudrun Østby•Social Science & Medicine•2019

Unique citing works7
Citations per year2,33
Citation span2023 - 2026 (4)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 7
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