Evidence map›Paper›PMID 34737857›Full record

SynthesisJournal of global health2021

Causes of maternal mortality in Sub-Saharan Africa: A systematic review of studies published from 2015 to 2020.

Reuben Musarandega, Michael Nyakura, Rhoderick Machekano, Robert Pattinson, Stephen Peter Munjanja

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 139 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
139citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

139 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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  4. Characteristics of longitudinal maternal health studies in sub-Saharan Africa: A systematic mapping of literature between 2012 and 2022.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
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  16. Global, regional, and national burden of maternal hemorrhage from 1990 to 2021, with projections to 2050: Insights from the Global Burden of Disease Study 2021.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
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  17. Validation of the miniPIERS model and a prognostic model for perinatal death in hypertensive pregnancy: Insights from the PREECARDIA study in Guinea-Bissau.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
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79 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Reuben MusarandegaSchool of Health Systems and Public Health, University of Pretoria, South Africa.
Michael NyakuraBiostatistics and Epidemiology Department, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Rhoderick MachekanoResearch Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, South Africa.
Robert PattinsonUnit of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Stephen Peter MunjanjaDepartment of Obstetrics and Gynaecology, Victoria Falls Hospital, Zimbabwe.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaternal deaths remain high in Sub-Saharan Africa (SSA) and their causes of maternal death must be analysed frequently in this region to guide interventions.

methodsWe conducted a systematic review of studies published from 2015 to 2020 that reported the causes of maternal deaths in 57 SSA countries. The objective was to identify the leading causes of maternal deaths using the international classification of disease - 10

resultsWe identified 38 studies that reported 11 427 maternal and four incidental deaths. Twenty-one of the third-eight studies were retrospective record reviews. The leading causes of death (proportions and 95% confidence intervals (CI)) were obstetric hemorrhage: 28.8% (95% CI = 26.5%-31.2%), hypertensive disorders in pregnancy: 22.1% (95% CI = 19.9%-24.2%), non-obstetric complications: 18.8% (95% CI = 16.4%-21.2%) and pregnancy-related infections: 11.5% (95% CI = 9.8%-13.2%). The studies reported few deaths of unknown/undetermined and incidental causes.

conclusionsLimitations of this review were the failure to access more data from government reports, but the study results compared well with WHO and GDB estimates. Obstetric hemorrhage, hypertensive disorders in pregnancy, non-obstetric complications, and pregnancy-related infections are the leading causes of maternal deaths in SSA. However, deaths from incidental causes are likely under-reported in this region. SSA countries must continue to invest in health information systems that collect and publishes comprehensive, quality, maternal death causes data. A publicly accessible repository of data sets and government reports for causes of maternal death will be helpful in future reviews. This review received no specific funding and was not registered.

Indexed as

Maternal DeathMaternal MortalityAfrica South of the SaharaFemaleHumansPregnancyPublicationsRetrospective Studies

Identifiers

PMID34737857
PMCPMC8542378

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.