Global Health Unit, Department of Health Sciences, University Medical Center Groningen, Groningen, the Netherlands.
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
J Glob Health. 2022 Aug 9;12:04066. doi: 10.7189/jogh.12.04066.
Sub-Saharan Africa (SSA) has the world's highest maternal and neonatal morbidity and mortality and has shown the slowest progress in reducing them. In addition, there is substantial inequality in terms of maternal and neonatal morbidity and mortality in the region. Geospatial studies can help prioritize scarce resources by pinpointing priority areas for implementation. This systematic review was conducted to explore the application of geospatial analysis to maternal and neonatal morbidity and mortality in SSA.
A systematic search of PubMed, SCOPUS, EMBASE, and Web of Science databases was performed. All observational and qualitative studies that reported on maternal or neonatal health outcomes were included if they used a spatial analysis technique and were conducted in a SSA country. After removing duplicates, two reviewers independently reviewed each study's abstract and full text for inclusion. Furthermore, the quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Finally, due to the heterogeneity of studies, narrative synthesis was used to summarize the main findings, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was strictly followed to report the review results. A total of 56 studies were included in the review.
We found that geospatial analysis was used to identify inequalities in maternal and neonatal morbidity, mortality, and health care utilization and to identify gaps in the availability and geographic accessibility of maternal health facilities. In addition, we identified a few studies that used geospatial analysis for modelling intervention areas. We also detected challenges and shortcomings, such as unrealistic assumptions used by geospatial models and a shortage of reliable, up-to-date, small-scale georeferenced data.
The use of geospatial analysis for maternal and neonatal health in SSA is still limited, and more detailed spatial data are required to exploit the potential of geospatial technologies fully.
撒哈拉以南非洲（SSA）拥有全球最高的孕产妇和新生儿发病率和死亡率，且在降低发病率和死亡率方面进展最慢。此外，该地区的孕产妇和新生儿发病率和死亡率存在巨大的不平等。地理空间研究可以通过确定实施的优先领域来帮助优先配置稀缺资源。本系统评价旨在探讨地理空间分析在 SSA 孕产妇和新生儿发病率和死亡率中的应用。
对 PubMed、SCOPUS、EMBASE 和 Web of Science 数据库进行系统检索。如果研究报告了孕产妇或新生儿健康结局，且使用了空间分析技术并在 SSA 国家进行，则纳入所有观察性和定性研究。去除重复项后，两名审查员独立审查了每篇研究的摘要和全文，以确定是否符合纳入标准。此外，还使用 Joanna Briggs 研究所（JBI）的批判性评估清单评估了研究的质量。由于研究之间存在异质性，因此采用叙述性综合法来总结主要发现，并严格遵循系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）指南报告综述结果。本综述共纳入 56 项研究。
我们发现，地理空间分析被用于识别孕产妇和新生儿发病率、死亡率和医疗保健利用方面的不平等，并确定孕产妇保健设施的供应和地理可及性方面的差距。此外，我们还发现了一些使用地理空间分析来确定干预区域的研究。我们还发现了一些挑战和缺点，例如地理空间模型中使用的不切实际的假设以及缺乏可靠、最新的小规模地理参考数据。
在 SSA，地理空间分析在孕产妇和新生儿健康方面的应用仍然有限，需要更详细的空间数据来充分利用地理空间技术的潜力。
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