Maternal mortality and its risk factors in Africa: A systematic review and meta-analysis

Background: Maternal mortality is a significant global health problem, which affects women of reproductive age. Maternal mortality is especially high in Africa, where more women die during pregnancy and childbirths from preventable causes. This review therefore aim to assess maternal mortality ratio and identify its risk factors. Methods: PubMed, Web of science, Embase, and Medline were searched for cohort, casecotrol and cross-sectonal studies published between 2008 and 2021that assessed maternal mortality or its risk risk in Africa, or among African women. The preferred reporting items for a systematic review and meta-analysis was carefully considered while conducting this review. Random effect model was used to generate pooled estimates. Data were analyzed using StataCorp version 16.0 statistical software. Results: A total of 1,657 articles were retrieved from searching four electronic databases. The sum of 1,639 records were excluded and a total of 18 studies were included into the the systematic review and meta-analysis. Using a random effect approach, this systematic review and meta-analysis estimated the MMR of 496/100,000 for Africa. Further, maternal age ≥ 35 years [OR = 2.50; 95% CI: (1.50, 4.15)], no formal education/illiterate mother [OR = 2.30; 95% CI: (1.50, 3.52)], no history of ANC attendance [OR = 2.42; 95% CI: (0.43, 13.50)], pregnancy complication/previous pregnancy-related illness [OR = 4.47; 95% CI: (3.03, 6.60)], delayed in seeking health care [OR = 5.12; 95% CI: (3.14, 8.34)], mother being referred [OR= 5.60; 95% CI: (4.16, 7.54)], and husband's education (illiterate/primary) [OR = 1.32; 95% CI: (0.69, 2.53)] were identified as risk factors of maternal mortality. Conclusion: A high MMR of 496/100,000 live birth for Africa was estimate in this review. Also, several risk factors of maternal mortality were identified. Healthcare professionals are therefore reminded to regularly educate mothers about the risk and benefits of seeking early prenatal healthcare