Maternal Mortality in Sub-Saharan Africa

Abstract

Maternal Mortality is a major global health challenge that has persistently defied solution, particularly in Sub-Saharan Africa. This systematic review aimed to examine the levels, methods of measurement and determinants of maternal mortality in Sub-Saharan Africa to identify new approaches in the measurement of maternal mortality and obtain accurate information on maternal mortality data between the period 1990-2020. A total of fifty-six (56) journal articles and grey literature that analyzed the levels, measurement and determinants of maternal mortality in Africa were extracted for review. Results show that maternal mortality ratio (MMR) was extremely high (>1000) in Chad, Sierra Leone and South Sudan, while it was extremely low (<100) in Mauritius, Cape Verde and Seychelles. The most common method of maternal mortality estimation was the sisterhood and sibling history found in about 40% of the studies reviewed. Our review also identified three studies that used innovative statistical techniques to estimate MMR. Of all the data sources, reproductive-age mortality studies (RAMOS) are considered the best approach in the absence of vital registration. Educational level, gender inequalities, early marriage, delivery assisted by traditional birth attendants, lack of access to emergency obstetric care, poor staff training, improved water source, sanitation and hygiene among others were significantly associated with maternal mortality.