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Maternal mortality in sub-Saharan Africa: the contribution of ineffective blood transfusion services

Bates, Imelda ORCID: https://orcid.org/0000-0002-0862-8199, Chapotera, G. K., McKew, S. and Van Den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2008) 'Maternal mortality in sub-Saharan Africa: the contribution of ineffective blood transfusion services'. BJOG: An International Journal of Obstetrics & Gynaecology, Vol 115, Issue 11, pp. 1331-1339.

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Abstract

In sub-Saharan Africa, where blood supply is critically inadequate, severe haemorrhage is a leading cause of maternal deaths. The aim of this review was to estimate the impact of lack of blood on maternal deaths and identify reasons and potential solutions. Databases and websites from 1970 to 2007 were searched for information concerning maternal deaths and near misses due to haemorrhage in sub-Saharan Africa. Original studies that provided qualitative or quantitative information about blood transfusion services in relation to obstetric deaths or near misses were included. Data about maternal haemorrhage deaths associated with lack of blood for transfusion and reasons for blood shortages were extracted from the full text of articles by two independent reviewers using predesigned, piloted forms. Twenty of 37 selected studies described a direct association between maternal deaths and lack of blood transfusions. Five of 37 provided quantitative information which showed that overall 26% (16-72%) of maternal haemorrhage deaths were due to lack of blood. Reasons included nonaffordability of blood, lack of blood donors, unwillingness of relatives to donate and inadequate supplies and transport. Lack of blood for emergency transfusions is a major, but poorly quantified and under-researched cause of maternal deaths in sub-Saharan Africa. Potential solutions include more blood donations, better financing mechanisms and more efficient management systems. Complementary approaches to prevent severe anaemia and treat hypovolaemia are important to reduce use of transfusions.

Item Type: Article
Uncontrolled Keywords: africa anaemia haemorrhage maternal mortality transfusion deaths tanzania morbidity hospitals nigeria region motherhood district gambia donors
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WB Practice of Medicine > Therapeutics > WB 356 Blood transfusion
WQ Obstetrics > Labor > WQ 330 Complications of labor
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Groups (2002 - 2012) > Disease Control Strategy Group
Digital Object Identifer (DOI): https://doi.org/10.1111/j.1471-0528.2008.01866.x
Depositing User: Tina Bowers
Date Deposited: 11 Aug 2010 09:26
Last Modified: 22 Oct 2019 08:20
URI: https://archive.lstmed.ac.uk/id/eprint/727

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