Background
Methods
Identification of literature and database management
Study variables
Data analysis
Results
Characteristics of the studies (Flow chart and Table 1 )
Health systems (830) Col. % | Health promotion (626) Col. % | Clinical intervention (1533) Col. % | Type of clinical intervention | Total % (column) | Total N | |||||
---|---|---|---|---|---|---|---|---|---|---|
APH/PPH (202) Col. % | Hypertension (232) Col. % | HIV (792) Col. % | STIs (122) Col. % | Malaria (283) Col. % | ||||||
Time period | ||||||||||
2000–2003 |
17.8
|
15.5
|
17.6
| 19.2 | 19.2 | 17.1 |
27.4
| 14.6 | 17.7 | 370 |
2004–2007 |
32.6
|
33.4
|
38.8
| 37.9 | 37.6 | 38.8 |
44.6
| 37.2 | 37.0 | 773 |
2008–2012 |
49.6
|
51.1
|
43.6
| 42.9 | 43.2 | 44.1 |
28.0
| 48.2 | 45.3 | 947 |
Economic regiona
| ||||||||||
LIC |
42.2
|
45.8
| 37.3 |
23.3
|
18.5
|
40.4
|
28.9
|
55
| 37.2 | 724 |
LMIC | 33.3 | 31.7 |
30.5
|
53.4
|
25.8
|
24
| 33 | 36.5 | 32.1 | 624 |
UMIC |
29
|
25.8
|
36.8
|
29.4
|
59.6
|
40.4
|
47.4
|
10.8
| 35.4 | 688 |
Geographic regiona
| ||||||||||
East Asia Pacific | 12.6 | 11.9 |
10.4
|
16
|
7.3
|
8.8
|
19.6
| 9.2 | 11.6 | 226 |
Europe, Central Asia | 2.5 | 2.4 | 3 |
6.1
|
9.9
|
1.7
| 4.1 |
0
| 3.2 | 63 |
Latin America, Caribbean | 17.1 | 16.3 |
15.1
| 16 |
29.1
| 15.4 |
26.8
|
0.8
| 16.7 | 325 |
Middle East, North Africa | 2.6 | 3 | 2.4 |
10.4
|
7.9
|
0
| 3.1 |
0
| 2.8 | 54 |
South Asia |
19.7
|
23.7
|
8.7
|
25.2
|
21.2
|
4.5
| 9.3 |
2.8
| 13.7 | 267 |
Sub-Saharan Africa |
48.9
|
45.7
|
63.6
|
39.3
|
31.1
|
70.8
|
43.3
|
88
| 55.4 | 1080 |
Multi-country study | ||||||||||
Multi-country study | 7.1 | 5.9 | 7.7 | 9.9 | 7.3 | 8.5 | 6.6 | 5.3 | 7.2 | 166 |
Study design | ||||||||||
Systematic review |
6.5
|
9.7
|
10.6
|
11.4
|
30.6
|
5.7
|
9.8
|
9.2
| 10.8 | 247 |
Effectiveness research |
69.9
|
61.5
|
60.5
|
57.4
|
49.1
|
65.9
|
62.3
|
55.8
| 61.4 | 1408 |
RCT |
5.2
|
11.2
|
15.8
|
21.8
|
15.1
|
12.8
|
9.8
|
21.2
| 13.1 | 301 |
Qualitative study |
7.1
|
7.7
|
4
|
1.5
|
0.9
|
5.9
|
1.6
|
2.5
| 5.3 | 121 |
Modelling |
7.5
|
4.5
|
6.7
|
5.9
|
3.9
|
6.9
|
14.8
|
7.8
| 6.5 | 148 |
Mixed methods research |
3.9
|
5.4
|
2.5
|
2
|
0.4
|
2.8
|
1.6
|
3.5
| 2.9 | 67 |
Impact Factor | ||||||||||
None |
61.3
|
63.1
|
57.6
|
61.4
|
47.4
|
59
|
47.5
|
66.4
| 58.8 | 1348 |
0–1 |
18.3
|
15.8
|
15.5
|
24.8
|
31
|
11.4
|
17.2
|
7.4
| 16.4 | 375 |
2–4 |
15.2
|
15.2
|
18
|
8.4
|
14.7
|
18.4
|
32
|
19.1
| 16.8 | 385 |
≥ 5 |
5.2
|
5.9
|
8.9
|
5.4
|
6.9
|
11.2
|
3.3
|
7.1
| 8 | 184 |
Study examines inequalities | ||||||||||
Yes |
14.3
|
20.9
|
5.9
| 9.9 |
2.2
|
4.5
|
4.1
| 10.2 | 9 | 206 |
Period targeteda
| ||||||||||
Pregnancy |
62.8
| 70.6 |
76.7
|
17.3
|
85.8
|
80.2
|
95.9
|
96.5
| 70.4 | 1613 |
Childbirth |
65.5
|
59.6
|
41.2
|
89.1
| 44.8 |
44.7
|
22.1
|
9.5
| 49.9 | 1144 |
Postpartum |
40.7
|
41.2
|
27.8
| 32.7 |
13.8
|
39
|
18
|
12.7
| 32 | 734 |
Intervention recipienta
| ||||||||||
Women |
56.3
| 78 |
88.6
| 75.7 |
85.3
|
89.9
| 77.9 |
90.8
| 79.1 | 1812 |
Males |
4.1
|
10.5
| 2.7 |
1
|
0
|
4.5
| 3.3 |
0.4
| 3.1 | 72 |
Family |
4.8
|
7.8
|
1.9
| 3 |
0
|
1.5
| 0.8 | 3.9 | 2.7 | 63 |
Community |
8.6
|
16.9
|
2.3
| 5.4 |
0.9
|
1.5
|
0
| 3.9 | 4.6 | 106 |
TBA |
8.4
|
13.3
|
1.7
|
9.4
|
1.7
|
0.1
|
0
| 2.5 | 3.9 | 89 |
Medical doctor |
15.7
|
8.5
|
3.7
|
13.9
| 8.2 |
2.7
|
2.5
|
1.4
| 6.7 | 154 |
HCW other than doctor |
25.5
|
14.1
|
5.7
|
19.8
|
7.3
|
4.5
| 7.4 |
2.8
| 11 | 251 |
Community health worker |
8
|
10.2
|
1.6
| 4 |
0.9
|
1.1
| 0.8 | 2.1 | 3.4 | 79 |
Managers and planners |
33.5
|
18.4
|
9.7
| 13.9 |
11.2
|
8.6
|
23.8
|
10.2
| 15.9 | 365 |
Includes health system component | ||||||||||
Yes | 100 |
64.5
|
14.9
|
29.7
|
14.7
|
12.8
|
23
|
17
| 36.2 | 830 |
Includes health promotion component | ||||||||||
Yes |
48.7
| 100 |
13.9
| 22.8 |
9.5
|
12.1
|
12.3
|
20.8
| 27.3 | 626 |
Outcomes reporteda
| ||||||||||
Maternal health |
42
|
44.6
|
62.5
|
77.2
|
84.9
|
49.4
| 62.3 |
70
| 56.2 | 1287 |
Child health |
24.1
|
29.7
|
45.5
|
13.9
|
53.9
|
49.5
| 38.5 |
49.8
| 38.9 | 891 |
Service delivery |
48.7
|
53
|
25.2
|
16.8
|
4.7
| 33.2 |
23
|
24
| 31.4 | 719 |
Health economics |
14.2
|
12.8
|
6.2
| 6.9 |
4.7
|
4.8
|
18
| 8.8 | 7.9 | 181 |
Other |
23.3
|
19
|
8.9
| 12.9 |
8.6
|
9
|
8.2
|
7.4
| 14.1 | 324 |
Comparisons across income and geographical regions (Additional file 2 : Table S1)
Changes over time (Table 2 )
Column % | 2000–2003 (370) | 2004–2007 (773) | 2008–2012 (1101) | Total % (column) |
---|---|---|---|---|
Economic zonea
| ||||
LIC | 36.9 | 34.4 | 39.5 | 37.3 |
LMIC |
29.6
|
31.1
|
34.4
| 32.4 |
UMIC |
37.9
|
38.7
|
31.4
| 35.1 |
Geographic zonea
| ||||
East Asia Pacific |
15.6
|
11
|
10.8
| 11.7 |
Europe, Central Asia | 2.9 | 3.9 | 3.1 | 3.3 |
Latin America, Caribbean | 15.9 | 18.5 | 14.6 | 16.2 |
Middle East, North Africa | 1.9 | 2.8 | 3.2 | 2.8 |
South Asia | 12.7 | 12.2 | 15.3 | 13.8 |
Sub-Saharan Africa | 54.5 | 55.2 | 56.6 | 55.7 |
Research topica (Figure 1) | ||||
APH/PPH | 9.5 | 8.9 | 8.3 | 8.7 |
Hypertension | 11.1 | 10.3 | 9.7 | 10.2 |
HIV | 33.5 | 36.5 | 33.8 | 34.7 |
STIs |
8.6
|
6.7
|
3.5
| 5.4 |
Malaria | 10.3 | 12.5 | 13.3 | 12.5 |
Health systems |
35.9
|
31.4
|
39.1
| 35.9 |
Health promotion |
23.5
|
24.2
|
30.2
| 27 |
Study design | ||||
Systematic review |
7.8
|
8.5
|
13.7
| 11 |
Effectiveness research | 63 | 63.8 | 59.7 | 61.6 |
RCT |
17.8
|
13.2
|
10.8
| 12.8 |
Qualitative study |
1.6
|
5.4
|
6.1
| 5.1 |
Modelling | 8.1 | 6.7 | 5.9 | 6.6 |
Mixed methods research |
1.6
|
2.3
|
3.8
| 2.9 |
Study examines inequalities | ||||
Inequalities examined |
6.5
|
8
|
10.4
| 9 |
Multi-country study | ||||
Multi-country study | 5.9 | 7.1 | 7.6 | 7.2 |
Health promotion topicsa
| ||||
Demand-side financing |
1.6
|
1.8
|
4.5
| 3.1 |
Patient transport | 1.9 | 1.3 | 2.6 | 2 |
Birth and complications preparedness | 5.7 | 5.3 | 4.5 | 5 |
Community participation in maternal death audits | 0.5 | 0.4 | 0.5 | 0.4 |
Maternal waiting homes |
0.8
|
0
|
1.6
| 0.9 |
Male involvement | 3.2 | 3.4 | 3.7 | 3.5 |
TBAs | 4.6 | 4 | 5.4 | 4.8 |