Maternal and perinatal death surveillance and response in low- and middle-income countries

A scoping review of implementation factors

Bibliographic Data

ID16763195
AuthorsMary V Kinney (0000-0002-2903-0161, University of the Western Cape, corresponding author), David Roger Walugembe (0000-0001-5752-8656, School of Health Studies and Faculty of Information and Media Studies, The University of Western Ontario, London, ON, Canada), Phillip Wanduru (0000-0001-5934-2505, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda), Peter Waiswa (0000-0001-8221-902X, Karolinska Institutet), Asha George (0000-0002-5968-1424, University of the Western Cape)
Year2021
Volume36
Issue6
Pages955-973
Publication date2021-06-25
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czab011
PMID33712840
OpenAlexW3134526474
LanguageEN
Citations received16
References cited68

Maternal and perinatal death surveillance and response (MPDSR), or any form of maternal and/or perinatal death review or audit, aims to improve health services and pre-empt future maternal and perinatal deaths. With expansion of MPDSR across low- and middle-income countries (LMIC), we conducted a scoping review to identify and describe implementation factors and their interactions. The review adapted an implementation framework with four domains (intervention, individual, inner and outer settings) and three cross-cutting health systems lenses (service delivery, societal and systems). Literature was sourced from six electronic databases, online searches and key experts. Selection criteria included studies from LMIC published in English from 2004 to July 2018 detailing factors influencing implementation of MPDSR, or any related form of MPDSR. After a systematic screening process, data for identified records were extracted and analysed through content and thematic analysis. Of 1027 studies screened, the review focuses on 58 studies from 24 countries, primarily in Africa, that are mainly qualitative or mixed methods. The literature mostly examines implementation factors related to MPDSR as an intervention, and to its inner and outer setting, with less attention to the individuals involved. From a health systems perspective, almost half the literature focuses on the tangible inputs addressed by the service delivery lens, though these are often measured inadequately or through incomparable ways. Though less studied, the societal and health system factors show that people and their relationships, motivations, implementation climate and ability to communicate influence implementation processes; yet their subjective experiences and relationships are inadequately explored. MPDSR implementation contributes to accountability and benefits from a culture of learning, continuous improvement and accountability, but few have studied the complex interplay and change dynamics involved. Better understanding MPDSR will require more research using health policy and systems approaches, including the use of implementation frameworks

Demographic economics · Developing country · Economic growth · Economics · Environmental health · Low and middle income countries · Low income · Food Security and Health in Diverse Populations · Global Maternal and Child Health · Global Public Health Policies and Epidemiology · Medicine

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