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Trends in maternal and neonatal mortality in South Africa: a systematic review

BACKGROUND: Measuring and monitoring progress towards Millennium Development Goals (MDG) 4 and 5 required valid and reliable estimates of maternal and child mortality. In South Africa, there are conflicting reports on the estimates of maternal and neonatal mortality, derived from both direct and ind...

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Autores principales: Damian, Damian J., Njau, Bernard, Lisasi, Ester, Msuya, Sia E., Boulle, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436230/
https://www.ncbi.nlm.nih.gov/pubmed/30917874
http://dx.doi.org/10.1186/s13643-019-0991-y
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author Damian, Damian J.
Njau, Bernard
Lisasi, Ester
Msuya, Sia E.
Boulle, Andrew
author_facet Damian, Damian J.
Njau, Bernard
Lisasi, Ester
Msuya, Sia E.
Boulle, Andrew
author_sort Damian, Damian J.
collection PubMed
description BACKGROUND: Measuring and monitoring progress towards Millennium Development Goals (MDG) 4 and 5 required valid and reliable estimates of maternal and child mortality. In South Africa, there are conflicting reports on the estimates of maternal and neonatal mortality, derived from both direct and indirect estimation techniques. This study aimed to systematically review the estimates made of maternal and neonatal mortality in the period from 1990 to 2015 in South Africa and determine trends over this period. METHODS: Nationally-representative studies reporting on maternal and neonatal mortality in South Africa were included for synthesis. Literature search for eligible studies was conducted in five electronic databases: Medline, Africa-Wide Information, Scopus, Web of Science and CINAHL. Searches were restricted to articles written in English and presenting data covering the period between 1990 and 2015. Reference lists of retrieved articles were screened for additional publications, and grey literature was searched for relevant documents for the review. Three independent reviewers were involved in study selection, data extractions and achieving consensus. RESULTS: In total, 969 studies were retrieved and 670 screened for eligibility yielding 25 studies reporting data on maternal mortality and 14 studies on neonatal mortality. Most of the studies had a low risk of bias. Estimates from the institutional reporting differed from the international metrics with wide uncertainty/confidence intervals. Moreover, modelled estimates were widely divergent from estimates obtained through empirical methods. In the last two decades, both maternal and neonatal mortality appear to have increased up to 2009, followed by a decrease, more pronounced in the care of maternal mortality. CONCLUSION: Estimates from both global metrics and institutional reporting, although widely divergent, indicate South Africa has not achieved MDG 4a and 5a goals but made a significant progress in reducing maternal and neonatal mortality. To obtain more accurate estimates, there is a need for applying additional estimation techniques which utilise available multiple data sources to correct for underreporting of these outcomes, perhaps the capture-recapture method. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016042769 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13643-019-0991-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-64362302019-04-08 Trends in maternal and neonatal mortality in South Africa: a systematic review Damian, Damian J. Njau, Bernard Lisasi, Ester Msuya, Sia E. Boulle, Andrew Syst Rev Research BACKGROUND: Measuring and monitoring progress towards Millennium Development Goals (MDG) 4 and 5 required valid and reliable estimates of maternal and child mortality. In South Africa, there are conflicting reports on the estimates of maternal and neonatal mortality, derived from both direct and indirect estimation techniques. This study aimed to systematically review the estimates made of maternal and neonatal mortality in the period from 1990 to 2015 in South Africa and determine trends over this period. METHODS: Nationally-representative studies reporting on maternal and neonatal mortality in South Africa were included for synthesis. Literature search for eligible studies was conducted in five electronic databases: Medline, Africa-Wide Information, Scopus, Web of Science and CINAHL. Searches were restricted to articles written in English and presenting data covering the period between 1990 and 2015. Reference lists of retrieved articles were screened for additional publications, and grey literature was searched for relevant documents for the review. Three independent reviewers were involved in study selection, data extractions and achieving consensus. RESULTS: In total, 969 studies were retrieved and 670 screened for eligibility yielding 25 studies reporting data on maternal mortality and 14 studies on neonatal mortality. Most of the studies had a low risk of bias. Estimates from the institutional reporting differed from the international metrics with wide uncertainty/confidence intervals. Moreover, modelled estimates were widely divergent from estimates obtained through empirical methods. In the last two decades, both maternal and neonatal mortality appear to have increased up to 2009, followed by a decrease, more pronounced in the care of maternal mortality. CONCLUSION: Estimates from both global metrics and institutional reporting, although widely divergent, indicate South Africa has not achieved MDG 4a and 5a goals but made a significant progress in reducing maternal and neonatal mortality. To obtain more accurate estimates, there is a need for applying additional estimation techniques which utilise available multiple data sources to correct for underreporting of these outcomes, perhaps the capture-recapture method. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016042769 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13643-019-0991-y) contains supplementary material, which is available to authorized users. BioMed Central 2019-03-27 /pmc/articles/PMC6436230/ /pubmed/30917874 http://dx.doi.org/10.1186/s13643-019-0991-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Damian, Damian J.
Njau, Bernard
Lisasi, Ester
Msuya, Sia E.
Boulle, Andrew
Trends in maternal and neonatal mortality in South Africa: a systematic review
title Trends in maternal and neonatal mortality in South Africa: a systematic review
title_full Trends in maternal and neonatal mortality in South Africa: a systematic review
title_fullStr Trends in maternal and neonatal mortality in South Africa: a systematic review
title_full_unstemmed Trends in maternal and neonatal mortality in South Africa: a systematic review
title_short Trends in maternal and neonatal mortality in South Africa: a systematic review
title_sort trends in maternal and neonatal mortality in south africa: a systematic review
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436230/
https://www.ncbi.nlm.nih.gov/pubmed/30917874
http://dx.doi.org/10.1186/s13643-019-0991-y
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