Chersich Matthew, Blaauw Duane, Dumbaugh Mari, Penn-Kekana Loveday, Thwala Siphiwe, Bijlmakers Leon, Vargas Emily, Kern Elinor, Kavanagh Josephine, Dhana Ashar, Becerra-Posada Francisco, Mlotshwa Langelihle, Becerril-Montekio Victor, Mannava Priya, Luchters Stanley, Pham Minh Duc, Portela Anayda Gerarda, Rees Helen
Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Centre for Health Policy and MRC Health Policy Research Group, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Global Health. 2016 Sep 6;12(1):52. doi: 10.1186/s12992-016-0189-1.
Progress in achieving maternal health goals and the rates of reductions in deaths from individual conditions have varied over time and across countries. Assessing whether research priorities in maternal health align with the main causes of mortality, and those factors responsible for inequitable health outcomes, such as health system performance, may help direct future research. The study thus investigated whether the research done in low- and middle-income countries (LMICs) matched the principal causes of maternal deaths in these settings.
Systematic mapping was done of maternal health interventional research in LMICs from 2000 to 2012. Articles were included on health systems strengthening, health promotion; and on five tracer conditions (haemorrhage, hypertension, malaria, HIV and other sexually transmitted infections (STIs)). Following review of 35,078 titles and abstracts in duplicate, data were extracted from 2292 full-text publications.
Over time, the number of publications rose several-fold, especially in 2004-2007, and the range of methods used broadened considerably. More than half the studies were done in sub-Saharan Africa (55.4 %), mostly addressing HIV and malaria. This region had low numbers of publications per hypertension and haemorrhage deaths, though South Asia had even fewer. The proportion of studies set in East Asia Pacific dropped steadily over the period, and in Latin America from 2008 to 2012. By 2008-2012, 39.1 % of articles included health systems components and 30.2 % health promotion. Only 5.4 % of studies assessed maternal STI interventions, diminishing with time. More than a third of haemorrhage research included health systems or health promotion components, double that of HIV research.
Several mismatches were noted between research publications, and the burden and causes of maternal deaths. This is especially true for South Asia; haemorrhage and hypertension in sub-Saharan Africa; and for STIs worldwide. The large rise in research outputs and range of methods employed indicates a major expansion in the number of researchers and their skills. This bodes well for maternal health if variations in research priorities across settings and topics are corrected.
实现孕产妇健康目标的进展以及因个别疾病导致的死亡率下降幅度随时间推移和国家不同而有所变化。评估孕产妇健康方面的研究重点是否与主要死亡原因以及导致健康结果不公平的因素（如卫生系统绩效）相一致，可能有助于指导未来的研究。因此，该研究调查了低收入和中等收入国家（LMICs）开展的研究是否与这些地区孕产妇死亡的主要原因相匹配。
对2000年至2012年期间低收入和中等收入国家孕产妇健康干预研究进行了系统映射。纳入的文章涉及卫生系统加强、健康促进；以及五种追踪疾病（出血、高血压、疟疾、艾滋病毒和其他性传播感染（STIs））。在对35078篇标题和摘要进行双人重复评审后，从2292篇全文出版物中提取了数据。
随着时间的推移，出版物数量增长了几倍，尤其是在2004 - 2007年，并且所使用的方法范围大幅拓宽。超过一半的研究在撒哈拉以南非洲进行（55.4%），主要涉及艾滋病毒和疟疾。该地区每例高血压和出血死亡的出版物数量较少，不过南亚更少。在此期间，东亚太平洋地区开展的研究比例稳步下降，拉丁美洲在2008年至2012年期间也是如此。到2008 - 2012年，39.1%的文章包含卫生系统组成部分，30.2%包含健康促进内容。只有5.4%的研究评估了孕产妇性传播感染干预措施，且随着时间推移而减少。超过三分之一的出血研究包含卫生系统或健康促进组成部分，是艾滋病毒研究的两倍。
研究出版物与孕产妇死亡负担及原因之间存在若干不匹配之处。南亚尤其如此；撒哈拉以南非洲的出血和高血压情况；以及全球范围内的性传播感染情况。研究产出的大幅增加和所采用方法的范围表明研究人员数量及其技能有了重大扩展。如果纠正不同地区和主题研究重点的差异，这对孕产妇健康是个好兆头。
