Triangulating data sources for further learning from and about the MDSR in Ethiopia: a cross-sectional review of facility based maternal death data from EmONC assessment and MDSR system

Hadush, Azmach; Dagnaw, Ftalew; Getachew, Theodros; Bailey, Patricia; Lawley, R; Ruano, Ana Lorena

doi:10.1186/s12884-020-02899-8

Cited by 13 publications

(19 citation statements)

References 25 publications

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“…These challenges are endemic in SSA, where delivery at home and in unequipped primary care facilities is typical. First delay (delay in deciding to present at a health facility) and second delay (delay to move a patient to an appropriate level of care) are common because of poor health-seeking behaviours, long distances to health facilities, and lack of transport to tertiary institutions [ 19 , 39 , 45 ]. In Guinea, maternal death odds ratios were significantly elevated in cases transferred from another hospital [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Causes of maternal mortality in Sub-Saharan Africa: A systematic review of studies published from 2015 to 2020

et al. 2021

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Background Maternal deaths remain high in Sub-Saharan Africa (SSA) and their causes of maternal death must be analysed frequently in this region to guide interventions. Methods We conducted a systematic review of studies published from 2015 to 2020 that reported the causes of maternal deaths in 57 SSA countries. The objective was to identify the leading causes of maternal deaths using the international classification of disease – 10 th revision, for maternal mortality (ICD-MM). We searched PubMed, WorldCat Discovery Libraries Worldwide (including Medline, Web of Science, LISTA and CNHAL databases), and Google Scholar databases and citations, using the search words “maternal mortality”, “maternal death”, “pregnancy-related death”, “reproductive age mortality” and “causes” as MeSH terms or keywords. The last date of search from all databases was 21 May 2021. We included original research articles published in English and excluded articles that mentioned SSA country names without study results for those countries, studies that reported death from a single cause or assigned causes of death using computer models or incompletely broke down the causes of death. We exported, de-duplicated and screened the searches electronically in EndNote version 20. We selected the final articles by reading the titles, abstracts and full texts. Two authors searched the articles and assessed the risk of bias using a tool adapted from Montoya and others. Data from the articles were extracted onto an Excel worksheet and the deaths classified into ICD-MM groups. Proportions were calculated with 95% confidence intervals and compared for deaths attributed to each cause and ICD-MM group. We compared the results with WHO and Global Burden of Disease (GDB) estimates. Results We identified 38 studies that reported 11 427 maternal and four incidental deaths. Twenty-one of the third-eight studies were retrospective record reviews. The leading causes of death (proportions and 95% confidence intervals (CI)) were obstetric hemorrhage: 28.8% (95% CI = 26.5%-31.2%), hypertensive disorders in pregnancy: 22.1% (95% CI = 19.9%-24.2%), non-obstetric complications: 18.8% (95% CI = 16.4%-21.2%) and pregnancy-related infections: 11.5% (95% CI = 9.8%-13.2%). The studies reported few deaths of unknown/undetermined and incidental causes. Conclusions Limitations of this review were the failure to access more data from government reports, but the study results compared well with WHO and GDB estimates. Obstetric hemorrhage, hypertensive disorders in pregnancy, non-obstetric complications, and pregnancy-related infections are the leading causes of maternal deaths in SSA. However, deaths from incidental causes are likely under-reported in this region. SSA countries must continue to invest in health information systems that collect and publishes comprehensive, quality, maternal death causes data. A publicly accessible repository of data s...

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Section: Discussionmentioning

confidence: 99%

“…In Guinea, maternal death odds ratios were significantly elevated in cases transferred from another hospital [ 19 ]. In Ethiopia, the second delay contributed 40%, while the third delay (delay to receive adequate care when an appropriate facility is reached) contributed 22% of maternal deaths [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Causes of maternal mortality in Sub-Saharan Africa: A systematic review of studies published from 2015 to 2020

et al. 2021

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“…The distribution of included articles by country was as follows:, Algeria [60], Benin [78], Burkina Faso [122,143], Cameroon [99,133], Democratic Republic of Congo [55,82], Egypt [105], Eritrea [102], Ethiopia [57,62,71,72,74,86,130,131], Ghana [49,52,53,58,69,141], Guinea-Bissau [76], Kenya [63,91,110,123,142,145], Madagascar [79], Malawi [80,83,100,126,140], Morocco [44], Mozambique [59], Nigeria [42,43,45,47,48,54,56,65,67,89,…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Individual, health facility and wider health system factors contributing to maternal deaths in Africa: A scoping review

Muriithi

Banke-Thomas

Gakuo

et al. 2022

PLOS Glob Public Health

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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.

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“…7 Approximately 80 million units of blood were collected from voluntary donors globally each year, though only 2 million units were collected in sub-Saharan Africa (SSA), where the need is very high. 8 In SSA, a total of 18 million units of safe blood are required annually, but only 15% were collected. 9 This is also a common problem in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

“…12 About 30-50% of these deaths were attributable to postpartum hemorrhage (PPH) and more than two-thirds of mothers die without getting a blood transfusion. 8 Besides, the global magnitude of injuries and death as a result of motor vehicle accidents is increasing, particularly in developing countries, including SSA. 13 The majority of these deaths after traumatic injuries are as a result of hemorrhage which could be averted through transfusion of blood.…”

Section: Introductionmentioning

confidence: 99%

Willingness to donate blood and associated factors among patient caregivers at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia

Kebede

Bitew

Birku

et al. 2022

Clinical Epidemiology and Global Health

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Background: Ethiopia is one of the countries with a significant shortage of medical blood. Patient caregivers can serve as an important pool of potential blood donors for many reasons. However, limited data are available on the willingness of patient caregivers to donate blood in Ethiopia. Therefore, this study assessed patient caregivers' willingness to donate blood and associated factors in northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted among 342 patient caregivers at the University of Gondar Comprehensive Specialized Hospital. A systematic random sampling technique was used to select the study participants. Data were collected using a pretested and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and exported to SPSS version 25 for analysis. The level of significance in the last model was declared based on a p-value of <0.05. Results: Patients caregivers' willingness to donate blood was 78.1% (95% CI: 74, 82). Attending primary (AOR = 2.91; 95% CI: 1.13, 7.54) and secondary education (AOR = 2.95; 95% CI: 1.19, 7.28), favorable attitude towards blood donation (AOR = 4.94; 95% CI: 2.62, 9.28), adequate knowledge of blood donation (AOR = 2.49; 95% CI: 1.18, 5.22), and ever donated blood (AOR = 3.95; 95% CI: 1.13, 13.84) were identified as significantly associated with willingness to donate blood. Conclusion: In this study, more than three-quarters of patient caregivers were willing to donate blood. Community encouragement and continuous awareness and motivational speeches about the need for blood donations within the community and in medical facilities would have been important to motivate patient caregivers to donate blood.

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Triangulating data sources for further learning from and about the MDSR in Ethiopia: a cross-sectional review of facility based maternal death data from EmONC assessment and MDSR system

Cited by 13 publications

References 25 publications

Causes of maternal mortality in Sub-Saharan Africa: A systematic review of studies published from 2015 to 2020

Causes of maternal mortality in Sub-Saharan Africa: A systematic review of studies published from 2015 to 2020

Individual, health facility and wider health system factors contributing to maternal deaths in Africa: A scoping review

Willingness to donate blood and associated factors among patient caregivers at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia

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