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Maternal death and obstetric care audits in Nigeria: a systematic review of barriers and enabling factors in the provision of emergency care.
- Source :
- Reproductive Health; 4/22/2016, Vol. 13, p1-11, 11p, 1 Diagram, 2 Charts, 1 Graph
- Publication Year :
- 2016
-
Abstract
- Background: Maternal death reviews and obstetric audits identify causes and circumstances related to occurrence of a maternal death or serious complication and inform improvements in quality of care. Given Nigeria's high maternal mortality, the lessons learned from past experiences can provide a good evidence base for informed decision making. We aimed to synthesise findings from maternal death reviews and other obstetric audits conducted in Nigeria through a systematic review, seeking to identify common barriers and enabling factors related to the provision of emergency obstetric care. Methods: We searched for maternal death reviews and obstetric care audits reported in the published literature from 2000-2014. A 'best-fit' framework approach was used to extract data using a structured data extraction form. The articles that met the inclusion criteria were assessed using a nine point quality score. Results: Of the 1,841 abstracts and titles at initial screening, 329 full text articles were reviewed and 43 papers fulfilled the inclusion criteria. Four types of barriers were reported related to: transport and referral; health workers; availability of services; and organisational factors. Three elements stand out in Nigeria as contributing to maternal mortality: delays in Caesarean section, unavailability of magnesium sulphate and lack of safe blood transfusion services. Conclusions: Obstetric care reviews and audits are useful activities to undertake and should be promoted by improving the processes used to conduct them, as well as extending their implementation to rural and basic level health facilities and to the community. Urgent areas for quality improvement in obstetric care, even in tertiary and teaching hospitals should focus on organisational factors to reduce delays in conducting Caesarean section and making blood and magnesium sulphate available for all who need these interventions. [ABSTRACT FROM AUTHOR]
- Subjects :
- OBSTETRICAL emergencies
MATERNAL health services
ACADEMIC medical centers
AUDITING
BLOOD transfusion
CESAREAN section
CINAHL database
EMERGENCY medical services
HEALTH services accessibility
MEDICAL information storage & retrieval systems
MAGNESIUM sulfate
MEDICAL quality control
MEDICAL referrals
MEDLINE
MATERNAL mortality
QUALITY assurance
RESEARCH funding
SYSTEMATIC reviews
TRANSPORTATION of patients
HOSPITAL ancillary services
TREATMENT delay (Medicine)
TERTIARY care
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 17424755
- Volume :
- 13
- Database :
- Complementary Index
- Journal :
- Reproductive Health
- Publication Type :
- Academic Journal
- Accession number :
- 114938708
- Full Text :
- https://doi.org/10.1186/s12978-016-0158-4