A scoping review of maternal mortality, its health determinants, and factors that influence care utilization in women of child-bearing years in Nigeria

Abstract

Objectives

This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria. The review specifically addresses the difficulties faced in assessing medical care, and the ongoing initiatives to lower the maternal mortality ratio.

Methods

Primary studies (published after year 2000) focused on maternal mortality, health determinants, and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases, including Scopus, PubMed, Google Scholar, and Web of Science. These were screened using defined inclusion and exclusion criteria. Data from these studies were extracted and thematically analysed to identify common themes and trends.

Results

A total of 21 publications were included in this review comprising 2 qualitative, 17 quantitative, and 2 mixed study designs. Major health determinants identified in these studies include hypertensive disorders of pregnancy, haemorrhage, and sepsis/septicaemia, contributing as much as 29 %, 24 %, and 14.2 % of maternal deaths respectively in over 10 % of the reviewed studies. Similarly, social-economic determinants including poverty, maternal education, health system issues and culture significantly impacted the utilization of maternal healthcare services, inadvertently impacting maternal mortality. Despite various maternal health interventions such as the “Abiye” Safe Motherhood Initiative, the Integrated Maternal, Newborn, and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies, early childbearing, unemployment, large family sizes, and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.

Conclusion

This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality, its health determinants, and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.