Investigating the State of Maternal Mortality in Jamaica: A Scoping Review Público
Spence, Tianni (Summer 2022)
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
About this Master's Thesis
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