Maternal and perinatal death surveillance and response in low- and middle-income countries: A scoping review of implementation factors

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Date
2021Author
Kinney, Mary V.
Walugembe, David Roger
Wanduru, Phillip
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Maternal and perinatal death surveillance and response (MPDSR), or any form of maternal and/or
perinatal death review or audit, aims to improve health services and pre-empt future maternal and
perinatal deaths. With expansion of MPDSR across low- and middle-income countries (LMIC), we
conducted a scoping review to identify and describe implementation factors and their interactions.
The review adapted an implementation framework with four domains (intervention, individual,
inner and outer settings) and three cross-cutting health systems lenses (service delivery, societal
and systems). Literature was sourced from six electronic databases, online searches and key
experts. Selection criteria included studies from LMIC published in English from 2004 to July 2018
detailing factors influencing implementation of MPDSR, or any related form of MPDSR. After a systematic screening process, data for identified records were extracted and analysed through content
and thematic analysis. Of 1027 studies screened, the review focuses on 58 studies from 24 countries, primarily in Africa, that are mainly qualitative or mixed methods. The literature mostly examines implementation factors related to MPDSR as an intervention, and to its inner and outer setting,
with less attention to the individuals involved. From a health systems perspective, almost half the
literature focuses on the tangible inputs addressed by the service delivery lens, though these are
often measured inadequately or through incomparable ways.