Interventions to reduce maternal mortality in developing countries: a systematic synthesis of evidence

Wilson, Amie (2014). Interventions to reduce maternal mortality in developing countries: a systematic synthesis of evidence. University of Birmingham. Ph.D.

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Abstract

Background: Every year 287,000 women die from pregnancy related complications.
Methods: Systematic reviews of interventions to reduce maternal mortality in developing countries with meta-analysis or meta-synthesis where appropriate.
Results: Participatory learning and actions cycles with women’s groups significantly reduce maternal and neonatal mortality, training and supporting TBAs also reduces perinatal mortality. Clinical officers performing caesareans section do not seem to cause any more maternal or perinatal mortalities than doctors. Prophylactic antibiotics reduce infectious morbidity in surgical abortion, yet the effect on miscarriage surgery is unclear. Cell salvage in ectopic pregnancy and caesarean section appear to be a safe and effective alternative in the absence of homologous transfusion. Motivational interviews may have potential to improve contraceptive use short term. Symphysiotomy may be a safe alternative to caesarean section. The anti-shock garment may improve outcomes when used in addition to standard obstetric haemorrhage management. Potential solutions to emergency transport for pregnant women include motorcycle ambulance programmes, collaboration with local minibus taxis services, and community education and insurance schemes.
Conclusion: Several interventions reviewed in this thesis can be utilised to aid reduction in maternal mortality, however the level of evidence available within each review varies, some allowing firm inferences with others more tentative.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

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