A global analysis of the determinants of maternal health and transitions in maternal mortality

作者：João Paulo Souza, Louise T. Day, Ana Clara Rezende-Gomes, Jun Zhang, Rintaro Mori, Adama Baguiya, Kapila Jayaratne, Alfred Osoti, Joshua P. Vogel, Oona M. R. Campbell, Kidza Mugerwa, Pisake Lumbiganon, Özge Tunçalp, Jenny A. Cresswell, Lale Say, Allisyn C. Moran, Olufemi T. Oladapo · 发表于：The Lancet Global Health · 年份：2023 · DOI：10.1016/s2214-109x(23)00468-0 · 被引用次数：384 · 研究领域：Global Maternal and Child Health、Global Health Care Issues、Climate Change and Health Impacts

The reduction of maternal mortality and the promotion of maternal health and wellbeing are complex tasks. This Series paper analyses the distal and proximal determinants of maternal health, as well as the exposures, risk factors, and micro-correlates related to maternal mortality. This paper also examines the relationship between these determinants and the gradual shift over time from a pattern of high maternal mortality to a pattern of low maternal mortality (a phenomenon described as the maternal mortality transition). We conducted two systematic reviews of the literature and we analysed publicly available data on indicators related to the Sustainable Development Goals, specifically, estimates prepared by international organisations, including the UN and the World Bank. We considered 23 frameworks depicting maternal health and wellbeing as a multifactorial process, with superdeterminants that broadly affect women's health and wellbeing before, during, and after pregnancy. We explore the role of social determinants of maternal health, individual characteristics, and health-system features in the production of maternal health and wellbeing. This paper argues that the preventable deaths of millions of women each decade are not solely due to biomedical complications of pregnancy, childbirth, and the postnatal period, but are also tangible manifestations of the prevailing determinants of maternal health and persistent inequities in global health and socioeconomic development. Th...