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. 2023 Jun 22;9(6):e17559.
doi: 10.1016/j.heliyon.2023.e17559. eCollection 2023 Jun.

Effectiveness of a continuum of care in maternal health services on the reduction of maternal and neonatal mortality: Systematic review and meta-analysis

Muluwas Amentie Zelka  1   2 , Alemayehu Work Yalew  3 , Gurmesa Tura Debelew  4
Affiliations

Effectiveness of a continuum of care in maternal health services on the reduction of maternal and neonatal mortality: Systematic review and meta-analysis

Muluwas Amentie Zelka et al. Heliyon. .

Abstract

Background: Sustainable Development Goals -3 (SDG - 3) were to ensure healthy live and promote well-being by reducing global maternal and neonatal deaths. These were to be implemented through the concept of continuum of care in maternal health program framework to improve health outcomes. There is a paucity of published evidences; as such, this review is designed to assess the effectiveness of the concept of continuum of care in maternal and neonatal health services on the reduction of maternal and neonatal mortality.

Methods: A search was conducted using the key words; maternal and neonatal, health services, continuum of care, maternal and neonatal mortality. Search focused on PubMed, Cochrane, MEDLINE and Google Scholar. Extractions of articles were done based on predetermine criteria. Data were compiled, and screened, entered and analysis was done using STATA 13 and Rev. Man. software. Effects of the intervention package were determined and the result was interpreted in random effect RR with 95%CI. The publication bias was determined by using funnel plot, Egger and Bagger test, heterogeneity, and sensitivity test.

Results: A total of 4685 articles were retrieved of these 20 articles reviewed. Articles on 631,975 live births (LBs) were analyzed. Results showed the distribution as follows; 23,126 newborns died within 28 days resulting [NMR = 35/1000LBs among the intervention group whereas NMR = 39/1000LBs among the control group]. The pooled effect of the intervention was significantly reduced neonatal mortality (RR = 0.84; 95%CI: 0.77-0.91). Similarly, 1268 women died during the pregnancy period up to 42 days after childbirth that resulted [MMR = 330/100,000LBs among the intervention group whereas MMR = 460/100,000LBs among the control group]. The pooled effect of the intervention was not a statistically significant association with maternal mortality (RR = 0.64; 95%CI: 0.41-1.00).

Conclusion: Adoption of continuum of care concepts in maternal health services reduced maternal and neonatal mortality. We recommend strengthening and effective implementation of a continuum of care in maternal health services to improve maternal and neonatal health care outcomes.

Keywords: Continuum; Health; Maternal; Mortality; Neonatal.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper

Figures

Fig. 1
Fig. 1
Flow chart of selection process of the studies for systematic review and meta-analysis (2000 – 2018).
Fig. 2
Fig. 2
Forest Plot on random effect of continuity of maternal health services on neonatal mortality, 2000-2018.
Fig. 3
Fig. 3
Funnel plot of meta-analysis on effect of continuity of maternal health services on neonatal mortality, 2000-2018.
Fig. 4
Fig. 4
Sensitivity test for a single study effect on overall pooled effect.
Fig. 5
Fig. 5
Forest Plot on random effect of continuity of maternal health services on maternal mortality, 2000-2018.
Fig. 6
Fig. 6
Funnel plot of meta-analysis on effect of continuity of maternal health services on maternal mortality, 2004-2018.
Fig. 7
Fig. 7
Sensitivity test for a single study effect on overall pooled effect.
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