Evidence-based practices to reduce maternal mortality: a systematic review.

Background: To achieve the World Health Organization's Millennium Development Goal of reducing maternal mortality by three-quarters by 2015, a strong global commitment is needed to address this issue in sub-Saharan Africa where the risk to women is greatest. A comprehensive international effort must include both clinical and community-based interventions. In sub-Saharan Africa where the majority of women deliver babies at home without a trained attendant, the national plans must rely predominantly on community-level interventions.

Methods And Results: This study compiles the Cochrane reviews whose outcome measure is maternal mortality. Nine reviews documented the effectiveness of specific drugs given during pregnancy while six reviews demonstrated that particular drug regimens and procedures actually increase maternal death. Two of the Cochrane reviews found no significant difference in maternal mortality risk due to antioxidant use or in training traditional births attendants.

Conclusions: The dearth of evidence highlights the need for increased focus on clinical and community-based interventions that are feasible in sub-Saharan Africa. This cannot be accomplished without a stronger commitment to reducing maternal mortality by global health practitioners and researchers.