Predictive value of institutional impact factor as an indirect measure of maternal mortality in Nigeria: A systematic review

Abstract

Background: This study developed a novel measure termed as an institutional impact factor (IIF), which was used for predicting the trends of maternal mortality ratio (MMR) resulting from poor management of the health system. Methods: A total of 3518 publications from Nigeria in PubMed from 1975 to 2005, were used to obtain IIF for each institution studied. The study periods compared, were period A (1975-1989), period B (1990-2004), and period C (1990-2005). Results: The public health sector period A mean ± standard error (SE) IIF was 1.423 ± 0.09, and dropped significantly in period B, to IIF of 0.704 ± 0.024, P < 0.001. Conversely, in period A, the mean ± SE MMR, was 508.8 ± 115.7/100,000 live births, and rose significantly in period B to MMR of 1895.5 ± 363.7/100,000 live births, P < 0.05. The linear regression model suggested a negative correlation between IIF and MMR. The overall, F (1,18) =15.5, P < 0.001, R2 was 0.463, BETA coefficient was − 0.68, P < 0.0001. The intercept 2957.6 was significant, P < 0.0001. We predicted that the Millennium Development Goals 5 required a 75% drop in MMR to 127/100,000 live births, and IIF rise to 1.69, in 2015. Conclusion: The IIF may be a health metric index for monitoring efficiency of the health workforce.