Maternal mortality in Cambodia, Thailand, Malaysia and Sri Lanka: a systematic review of local and national policy and practice initiatives.

Abstract

Review question / objective The primary objectives of this systematic review are to compare and evaluate the health policy positions across Cambodia, Thailand, Malaysia and Sri Lanka as they relate to maternal mortality and the provision of midwifery services. The specific questions this review will seek to address are: 1. What are the strategies to reduce maternal mortality in Cambodia, Thailand, Malaysia and Sri Lanka? 2. Which strategies have had the greatest impact in relation to a change in maternity care practice within the countries of interest? Inclusion Criteria Types of participants The review will consider studies that include: pregnant and birthing women who receive care from a skilled birth attendant. Types of intervention(s)/phenomena of interest The review will consider studies that describe: 1. The health system / service delivery structures and underlying policy. 2. The maternity care provided by a skilled birth attendant. Types of outcomes The primary outcomes of interest in this review are: Strategies that have reduced maternal mortality rates. Secondary outcomes of interest to this review include: Strategies that have had the greatest impact in relation to: a) Changes to health system structures related to pregnancy and childbirth (including resources / finances) b) Change in cultural practices related to pregnancy and birth c) Empowerment of women and their position in society (and what impact this has had with respect to their choice of pregnancy and birth care)