Kyei-Nimakoh Minerva, Carolan-Olah Mary, McCann Terence V
College of Health and Biomedicine, Victoria University, PO Box 14428, Melbourne, Victoria, 8001, Australia.
Syst Rev. 2015 Apr 23;4:54. doi: 10.1186/s13643-015-0045-z.
Since the launch of the Millennium Development Goals (MDGs) by the United Nations in 2000, the global community has intensified efforts to reduce adverse maternal health outcomes, especially, in sub-Saharan Africa. Despite these efforts, there is an increasing concern that the decline in maternal deaths has been less than optimal, even for women who receive birthing care in health facilities. High maternal deaths have been attributed to a variety of issues such as poor quality of care, inadequate resources, poor infrastructure, and inaccessibility to healthcare services. In other words, even in settings where they are available, many women do not receive life-saving obstetric care, when needed, despite the fact that basic and comprehensive obstetric care is widely recognized as a key to meeting maternal health goals. It is important to understand the common challenges that this developing region is facing in order to ensure a more rapid decline in adverse maternal health outcomes. The aim of this review is to synthesize literature on barriers to obstetric care at health institutions which focuses on sub-Saharan Africa, the region that is most affected by severe maternal morbidity and mortality.
This review follows guidelines by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. An electronic search of published literature will be conducted to identify studies which examined barriers to health facility-based obstetric care in sub-Saharan Africa. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases will be searched. Published articles in English, dated between 2000 and 2014, will be included. Combinations of search terms such as obstetric care, access, barriers, developing countries, and sub-Saharan Africa will be used to locate related articles, and eligible ones retained for data abstraction. A narrative synthesis approach will be employed to synthesize the evidence and explore relationships between included studies.
Information on the barriers to obstetric care is needed to inform policies for the improvement of maternal health. This review will contribute to providing related vital evidence to facilitate removal of barriers to maternal health services and interventions.
PROSPERO 2014:CRD42014015549 .
自2000年联合国发起千年发展目标（MDGs）以来，国际社会加大了努力以减少孕产妇不良健康结局，特别是在撒哈拉以南非洲地区。尽管做出了这些努力，但人们日益担忧孕产妇死亡人数的下降并不理想，即使是在医疗机构接受分娩护理的妇女也是如此。孕产妇死亡率高归因于多种问题，如护理质量差、资源不足、基础设施薄弱以及难以获得医疗服务。换句话说，即使在有医疗服务的地方，许多妇女在需要时也无法获得挽救生命的产科护理，尽管基本和全面的产科护理被广泛认为是实现孕产妇健康目标的关键。了解这个发展中地区面临的共同挑战对于确保孕产妇不良健康结局更快下降非常重要。本综述的目的是综合关于撒哈拉以南非洲地区医疗机构产科护理障碍的文献，该地区受严重孕产妇发病率和死亡率影响最大。
本综述遵循系统评价和荟萃分析的首选报告项目（PRISMA）清单指南。将对已发表的文献进行电子检索，以识别研究撒哈拉以南非洲地区基于医疗机构的产科护理障碍的研究。将检索PubMed、护理及相关健康文献累积索引（CINAHL）和Scopus数据库。将纳入2000年至2014年期间发表的英文文章。将使用诸如产科护理、可及性、障碍、发展中国家以及撒哈拉以南非洲等搜索词组合来查找相关文章，并保留符合条件的文章进行数据提取。将采用叙述性综合方法来综合证据并探索纳入研究之间的关系。
需要有关产科护理障碍的信息来为改善孕产妇健康的政策提供依据。本综述将有助于提供相关重要证据，以促进消除孕产妇健康服务和干预措施的障碍。
PROSPERO 2014：CRD42014015549
