The Barriers and Facilitators Created by Healthcare Management Systems (HMS) to Achieving Sustainable Development Goals (SDGs) Related to Reducing Maternal Mortality in Africa: A Metasynthesis of Evidence

Abstract

Background: Maternal mortality (MM) has been a continuous menace in Africa. Africa alone is responsible for about two-thirds of the total deaths caused by maternal mortality. The implication of Healthcare Management System (HMS) has been reported, however, not much emphasis has been placed on the barriers or facilitators created by HMS in addressing MM in Africa. Thus, this study aims to fill that gap. Research Methods: In adherence with the PRISMA framework, a predetermined search strategy was implemented to identify original research works published within the past decade and half, utilizing four advanced electronic databases including CINAHL, Medline (via PubMed), PsycInfo, and ProQuest. The collected information was categorized into distinctive themes and subsequently integrated to form innovative perspectives. Findings: A total of 6 studies included revealed two broad themes viz: barriers and facilitators. Domains formulated from these themes include health system barriers and facilitators, socio-cultural barriers and facilitators, and policy-related barriers and facilitators. This synthesis highlights the various factors affecting maternal mortality rate with relation to HMS. Community mobilization and health education can help overcome socio-cultural barriers. Access to obstetric care and a functional referral system are essential for improving skilled pregnancy care. Conclusion: This review exposed the barriers which can be changed, and also the facilitators which can be improved as created by HMS. By leveraging on the facilitators, it is believed that SDG-3.1 (reducing MM) will record significant gains in Africa.