Socioeconomic factors affecting maternal mortality in Sub- Saharan Africa: A scoping review

Abstract

Background: One of the most serious global health issues is maternal health. Maternal mortality is considered an important topic in global health and development debates.  Although  some  nations  have  achieved  significant improvements,  Sub-Saharan  Africa (SSA)  continues  to  account  for  half  of  all  maternal  fatalities  worldwide. There  is  a  consensus  concerning  the  importance  of  a  strong  health  system,  skilled  delivery  attendants,  and women's  rights  for  maternal  health.  There is no single easy, uncomplicated measure that can dramatically reduce maternal mortality; however, there is widespread agreement on the need for a robust health system, trained delivery attendants, and women's rights for maternal health. This study aims to identify socioeconomic factors associated with maternal mortality in Sub-Saharan Africa.

Methods: Peer-reviewed journal articles were collected from two databases (Medline and CINAHL) exploring quantitative and qualitative studies conducted in SSA (English language; between 2010 and 2021).  The five-stage methodological framework of Arskey and O’Malley for scoping reviews was followed. Extracted data was charted and summarized narratively. After removal of duplicates and screening against the inclusion criteria. Sixteen articles met the inclusion criteria.

Results: The  major  determinants  of  maternal  health  service usage  and  maternal  mortality  were  socioeconomic  class,  education,  caste/ethnicity,  religion,  and culture. The key intermediary factors were women's residence, maternal age during childbirth, number of children, and media exposure. In SSA, the health system has evolved as a critical and independent intermediary component in maternal health.

Conclusions:  Tailored programmes addressing cultural beliefs and attitudes, as well as low educational attainment, are required. Women's rights should be at the forefront of these activities. The creation of empirically validated metrics to assess and examine the link between women's empowerment and maternal health should be the focus of future research.