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

A scoping review

Dados Bibliográficos

ID19591506
AutoresFrancis G Muriithi (0000-0002-2314-5611, University of Birmingham, autor correspondente), 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)
EditoresHannah Hogan Leslie
Ano2022
Volume2
Fascículo7
Páginase0000385
Data de publicação2022-07-20
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoPLOS Global Public Health (JOURNAL)
Identificadores do periódicoISSN: 2767-3375 • E-ISSN: 2767-3375
EditoraPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000385
PMID36962364
OpenAlexW4286007853
IdiomaEN
Citações recebidas7
Referências citadas98

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