Investigating the State of Maternal Mortality in Jamaica: A Scoping Review Pubblico

Spence, Tianni (Summer 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/zk51vj38b?locale=it
Published

Abstract

Background: Maternal mortality is one of the world's most pervasive problems in low- and middle-income countries, with progress on reducing the maternal mortality ratio being slow in many nations. The maternal mortality ratio remains alarmingly high in Jamaica despite ongoing public health efforts.

Objectives: The purpose of this scoping literature review is to map the research on maternal mortality within Jamaica over the last two decades and identify any existing gaps in knowledge. Specific objectives of this review are to describe the accessibility and availability of maternal healthcare in Jamaica, describe the causes of maternal mortality in Jamaica over the past two decades and to describe the successes and challenges of maternal mortality surveillance in Jamaica over the past two decades.

Review Methods: PubMed, Web of Science, and EmBase were used to identify peer-reviewed articles. All full-text publications were entered using Zotero and Covidence, and then organized into a summary of findings table using Microsoft Excel.

Results: The literature search strategy identified 22 peer-reviewed articles related to maternal mortality in Jamaica over the past two decades. 10 full-text articles were included in this review. Studies fell into 4 themes: medical care (n=3), indirect causes (n=3), direct causes (n=2), and maternal mortality surveillance (n=2). It was found that approximately 90% of all pregnancy-related deaths on the island occur in hospital. While direct deaths decline, there has been an increase in indirect deaths. Successful interventions have worked to reduce maternal mortality from direct deaths; however, the indirect deaths have been trending upward, leading to no improvement in the overall maternal mortality ratio. Under and misreporting of deaths is a significant issue for the country.

Conclusion: Maternal mortality is a major public health concern for Jamaica. Several epidemiological research studies exist on direct and indirect causes of maternal mortality. Yet, minimal progress has been made in reducing the maternal mortality rate over the past two decades. Considering the obstetric and demographic shift that Jamaica is experiencing, an in-depth understanding of non-medical factors that contribute to the delay in reducing maternal mortality is needed.

 

Keywords: maternal mortality, maternal death, Jamaica, Caribbean, scoping review

Table of Contents

Acronyms and Abbreviations

Definitions

Chapter 1: Introduction

1.1: Thesis Overview

1.2: Background and Significance

1.3: The Setting of Jamaica

Healthcare in Jamaica

1.4: Rationale

Chapter 2: Literature Review

2.1: Maternal Mortality Overview

2.2: Maternal Mortality in Latin America and the Caribbean

2.3: History of Maternal Care in Jamaica

2.4: Summary

Chapter 3: Methods

3.1: Objectives

3.2: Conceptual Approach

3.3: Methodological Approach

3.4: Methods

Research Question

Identification of Literature

Inclusion and Exclusion Criteria

Data Collating and Comparison

3.5: Ethical Considerations

Chapter 4: Results

4.1: Synthesis of Results

4.2: Medical Care

4.3: Direct Causes of Deaths

4.4: Indirect Causes of Deaths

4.5: Jamaica Maternal Mortality Surveillance

Chapter 5: Discussion

5.1: Findings

Direct Deaths

Indirect Deaths

Maternal Mortality Surveillance

5.2: Strengths

5.3: Limitations

5.4: Public Health Implications

5.5: Recommendations

Chapter 6: Conclusion

References

Appendix

Table 1: Review of Eligible Studies

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