3 December 2013
A systematic review of research on the key causes of maternal deaths in low-middle income countries (LMICs) has found a marked gap between the need for research and the actual burden of mortality.
This large-scale review, undertaken by 33 people as part of the Multilateral Association for Studying Health Inequalities and Enhancing North-South and South-South Cooperation project (MASCOT -http://www.mascotfp7.eu/), mapped evidence of all maternal health literature from 2000 to 2012. The aim was to assess whether the distribution of this literature matched the burden of maternal mortality. A total of 2489 studies were analysed in this first stage of the MASCOT project.
Led by Dr Matthew Chersich of the Centre for Health Policy at the Wits School of Public Health in Johannesburg, the study found that the number of studies on maternal health has increased over time, from fewer than 900 in 2000 to double that in 2011.
“However, this mapping exercise showed that in Afghanistan, for example, there were only six studies between 2000 and 2012, equivalent to 0.3 studies per 1000 maternal deaths. On the other hand, Jamaica had the most favourable ratio with 222 studies per 1000 maternal deaths. South Africa has 52 studies per 1000 deaths, although a large proportion of these are on HIV,” said Dr Chersich.
The review also determined if vulnerable groups were targeted for clinical interventions, health systems interventions, health promotion, and community-based interventions targeting maternal health. The clinical interventions included were studies on haemorrhage, hypertension, HIV infections, sexually transmitted infections and malaria, which are key causes of maternal deaths in LMICs. It found that some regions in the world had half the focus on equity as other regions. Of concern is that fewer than 10% of the studies addressed vulnerable groups.
“This work helped the team to inform the WHO guidelines on health promotion for maternal health,” said Dr Chersich. “The report synthesises the available evidence and shows the global distribution of studies on maternal mortality and countries’ efforts to prevent it. We hope the maps will be useful to identify gaps in primary research, and assist policy makers and researchers to identify the most policy-relevant review topics,” he said.
To read the report, click here. For more on the recent partnership and research dissemination meeting in Mexico City, click here.
MASCOT is supported by the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 282507, from 1 October to 31 March 2014.