Barriers to Accessing Maternal Care in Low Income Countries in Africa: A Systematic Review.

Rana Dahab,Dikaios Sakellariou

doi:10.3390/ijerph17124292

Abstract

The new Sustainable Development Goals (SDGs) to 2030 aim to reduce maternal mortality and provide equitable access to maternal healthcare. Compromised access to maternal health facilities in low-income countries, and specifically in Africa, contribute to the increased prevalence of maternal mortality. We conducted a systematic review to investigate access barriers to maternal health in low-income countries in Africa since 2015, from the perspective of both community members and health providers. The findings show that the most important barriers to maternal health are transportation barriers to health facilities, economic factors, and cultural beliefs, in addition to lack of family support and poor quality of care. Further research is required to guide policymakers towards firm multi-sectoral action to ensure appropriate and equitable access to maternal health in line with the SDGs to 2030.

Highlights

Maternal health is a cornerstone for healthy and productive populations [1,2]
Studies had to meet all of the following inclusion criteria: peer-reviewed publications on maternal healthcare access in low-income countries (LICs) in Africa; women’s or healthcare workers’ (HCWs) perspectives on accessing maternal healthcare facilities (MHFs); qualitative and mixed-method research; published work in English language; full-text publications, with a publication date between 2015 and May 2019, because we wanted to investigate access to maternal care following the end of Millennium Development Goals (MDGs) in 2015
Findings from this review suggest that women in LICs are highly vulnerable as they suffer from poverty, lack of awareness of maternal healthcare benefits, transportation-related barriers to health facilities, and lack of autonomy, in addition to security concerns which prevent them from accessing maternal healthcare facilities, in agreement with previous research [40,43,44,45]

Summary

Introduction

Maternal health is a cornerstone for healthy and productive populations [1,2]. the UnitedNation’s (UN) Millennium Development Goals (MDGs) aimed to reduce global maternal mortality ratios by 75% by 2015 [3], there are still 830 women dying every day worldwide from preventable causes due to improper maternal care [4]. 99% of mortality cases take place in low-income countries (LICs), with more than half of these deaths occurring in Sub-Saharan Africa [5,6], where maternal mortality is still a persisting challenge.Goal 3 of the new Sustainable Development Goals (SDGs) to 2030 aims to reduce global maternal mortality ratio to less than 70 per 100,000 live births [5,7,8,9]. Nation’s (UN) Millennium Development Goals (MDGs) aimed to reduce global maternal mortality ratios by 75% by 2015 [3], there are still 830 women dying every day worldwide from preventable causes due to improper maternal care [4]. Insecurity and scarce resources are additional critical issues to maternal healthcare accessibility for women living in conflict zones and fragile settings [11]. These factors could contribute to high risk of maternal bleeding, complications, and infections during childbirth and unsafe abortions [7,12]. Evidence suggests that reducing global maternal mortality and providing equitable access to healthcare can have many benefits for societies, including increased productivity and higher educational attainment [13,14,15,16,17,18]

Methods

Results

Discussion

Conclusion