ArticleBJOG : an international journal of obstetrics and gynaecology2026
Variability in the Causes and Delay Factors Contributing to Maternal Mortality: Evidence From Maternal Death Surveillance Reports of 22 African Countries.
Article in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Global, regional and national burden of maternal haemorrhage (2000-2021) and projections to 2050 in 204 countries and territories.BMJ open · 2026Article
- Binational Analysis of Maternal Mortality Between Brazil and Portugal in 2020-2023: A Population-Based Epidemiological Study.Nursing reports (Pavia, Italy) · 2026Article
- Factors associated with birth preparedness and complication readiness knowledge among pregnant women before implementation of a culturally adapted training intervention in rural Iringa, Tanzania.Frontiers in global women's health · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo examine the variability in causes of maternal deaths in African countries using the World Health Organization (WHO) International Classification of Diseases Maternal Mortality (ICD-MM) framework and the contributing factors using the three delays framework.
designSecondary data analysis.
settingAfrican countries. SAMPLE: National maternal death review reports.
methodsA framework analysis of data extracted from maternal death review reports utilising the ICD-MM and three delays analytical frameworks.
main outcome measuresProportions of the causes of maternal death and contributing factors.
resultsTwenty-two reports published between 2009 and 2022 were included, comprising 18,321 maternal deaths. The mean proportions were: 73% direct, 20% indirect, 8% unspecified, and 1% coincidental. The causes of death consisted of: 6% abortion-related; 16% hypertensive disorders; 33% obstetric haemorrhage; 9% infection; 10% other direct complications; 3% complications of management; 20% non-obstetric complications; 8% unknown; and 1% coincidental. All three delays contributed to maternal deaths. The third delay: receiving adequate care, was the most common in all countries except Ethiopia, where the first delay: deciding to seek care, dominated. On average, the first, second, and third delays contributed to 26%, 15%, and 61% of deaths, respectively.
conclusionA renewed focus on the quality of care within health facilities, alongside addressing pre-facility contributing factors, could re-ignite progress in reducing the burden of preventable maternal deaths.
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