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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Maternal health interventions in resource limited countries: A systematic review of packages, impacts and factors for change
BMC Pregnancy and Childbirth, Volume 11, Article 30, Year 2011
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Description
Background: The burden of maternal mortality in resource limited countries is still huge despite being at the top of the global public health agenda for over the last 20 years. We systematically reviewed the impacts of interventions on maternal health and factors for change in these countries.Methods: A systematic review was carried out using the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles published in the English language reporting on implementation of interventions, their impacts and underlying factors for maternal health in resource limited countries in the past 23 years were searched from PubMed, Popline, African Index Medicus, internet sources including reproductive health gateway and Google, hand-searching, reference lists and grey literature.Results: Out of a total of 5084 articles resulting from the search only 58 qualified for systematic review. Programs integrating multiple interventions were more likely to have significant positive impacts on maternal outcomes. Training in emergency obstetric care (EmOC), placement of care providers, refurbishment of existing health facility infrastructure and improved supply of drugs, consumables and equipment for obstetric care were the most frequent interventions integrated in 52% - 65% of all 54 reviewed programs. Statistically significant reduction of maternal mortality ratio and case fatality rate were reported in 55% and 40% of the programs respectively. Births in EmOC facilities and caesarean section rates increased significantly in 71% - 75% of programs using these indicators. Insufficient implementation of evidence-based interventions in resources limited countries was closely linked to a lack of national resources, leadership skills and end-users factors.Conclusions: This article presents a list of evidenced-based packages of interventions for maternal health, their impacts and factors for change in resource limited countries. It indicates that no single magic bullet intervention exists for reduction of maternal mortality and that all interventional programs should be integrated in order to bring significant changes. State leaders and key actors in the health sectors in these countries and the international community are proposed to translate the lessons learnt into actions and intensify efforts in order to achieve the goals set for maternal health. © 2011 Nyamtema et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3090370/bin/1471-2393-11-30-S1.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC3090370/bin/1471-2393-11-30-S2.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC3090370/bin/1471-2393-11-30-S3.DOCX
Authors & Co-Authors
Nyamtema, Angelo Sadock
Tanzania, Ifakara
Tanzanian Training Centre for International Health Ifakara
Urassa, David P.
Tanzania, Dar es Salaam
School of Public Health and Social Sciences
van Roosmalen, Jos J.M.
Netherlands, Leiden
Leids Universitair Medisch Centrum
Netherlands, Amsterdam
Amsterdam Umc - Vrije Universiteit Amsterdam
Statistics
Citations: 194
Authors: 3
Affiliations: 4
Identifiers
Doi:
10.1186/1471-2393-11-30
e-ISSN:
14712393
Research Areas
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Study Approach
Systematic review