Evidence map›Paper›PMID 41462176›Full record

SynthesisBMC public health2025

Maternal mortality in Ethiopia (2015-2025): a systematic review of recent evidence and determinants.

Merga Abdissa Aga, Ding-Geng Chen

Abstract readSystematic Review
In one paragraph

Synthesis in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

2 authors.

Merga Abdissa AgaDepartment of Statistics, Salale University, Fiche, Ethiopia. mergabdisa3@gmail.com.
Ding-Geng ChenCollege of Health Solutions, Arizona State University, Phoenix, AZ, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite major policy reforms and improvements in healthcare coverage, maternal mortality remains a critical public health burden in Ethiopia. While progress has been made since the Millennium Development Goals era, the maternal mortality ratio (MMR) still exceeds national and global targets. This systematic review synthesizes evidence from the past decade (2015-2025) to describe the magnitude, determinants, and regional disparities of maternal mortality in Ethiopia, highlighting persistent challenges and future priorities.

methodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines (registered in International Prospective Register of Systematic Reviews (PROSPERO)), we systematically searched PubMed, Scopus, Web of Science, Embase, Cochrane, and African Journal Online(AJOL), supplemented with grey literature from World Health Organization (WHO), United Nations International Children's Emergency Fund (UNICEF), and the Ethiopian Ministry of Health. Studies published in English between January 2015 and September 2025 was included. Data extraction followed standardized templates, and study quality was appraised using Joanna Briggs Institute (JBI) and Newcastle-Ottawa Scale (NOS) tools. Given methodological heterogeneity, a narrative synthesis approach was applied.

resultsA total of 61 studies met inclusion criteria, encompassing all Ethiopian regions. The pooled MMR was estimated at 366.6 maternal deaths per 100,000 live births, showing only modest progress from previous decades. The leading causes of maternal death were obstetric hemorrhage (29.6%), hypertensive disorders (22.1%), sepsis (14.8%), obstructed labor (11.3%), and unsafe abortion (8.5%). Determinants aligned with the three-delay model: (1) delayed decision-making from low awareness and sociocultural barriers; (2) delayed access due to distance, transport, and cost; and (3) delayed care from health-system shortages and weak referral mechanisms. Socioeconomic inequality, inadequate antenatal care (< 4 visits), rural residence, and low maternal education consistently increased risk.

conclusionsMaternal mortality in Ethiopia remains unacceptably high yet preventable. Persistent inequities, poor service quality, and health-system gaps continue to drive maternal deaths. Despite national initiatives such as the Health Sector Transformation Plan II (2015-2025) and the Maternal and Child Health Roadmap, progress is uneven. Achieving the SDG 3.1 target of < 70 deaths per 100,000 live births by 2030 demands stronger referral systems, equitable resource distribution, and quality-focused maternal health interventions. Targeted regional interventions and stronger Emergency Obstetric and Newborn Care (EmONC) readiness are essential for achieving the Sustainable Development Goals (SDG) 3.1 target. Future research should integrate longitudinal, spatial, machine learning and Bayesian models to pinpoint high-risk areas and evaluate the impact of health-system reforms.

Indexed as

Maternal MortalityEthiopiaFemaleHumansPregnancyDeterminantsEthiopiaGaps for Future ResearchMaternal mortalitySystematic review

Identifiers

PMID41462176
PMCPMC12888282

What OpenQuestion holds

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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.