Background
Aim
Methods
Protocol and registration
Eligibility criteria
Information sources
Search
Study selection
Data collection process
Data items
Risk of bias in individual studies
No. | Criteria | Attributes | Risk of bias |
---|---|---|---|
1. | Definition of maternal mortality | ❖ ICD-10 maternal death definition [85], or similar | Low |
❖ No or unclear definition provided | High | ||
2. | Definition of neonatal mortality | ❖ Death of live-born within the first 28 days of life, or similar | Low |
❖ No or unclear definition provided | High | ||
3. | Completeness of ascertainment of maternal and neonatal deaths | ❖ Prospective recording of mortality data ❖ Mixed methods cross-referencing facility records ❖ Demographic surveillance system with frequent rounds ❖ Survey based on recall of maternal or neonatal deaths ≤ 6 months previously | Low |
❖ Survey using direct or indirect sisterhood estimation methods ❖ Demographic surveillance system with infrequent rounds. | High | ||
4. | Completeness of ascertainment of live births | ❖ Prospective recording of births data ❖ Use of census < 5 years old for live births | Low |
❖ Use of census ≥ 5 years old for live births ❖ Live births data source not stated or unclear | High | ||
5. | Sampling technique/design | ❖ Census ❖ Vital registration ❖ Survey using nationally representative sample ❖ Systematic analysis involving the use of data collected from the above method(s) | Low |
❖ Design or sampling techniques not stated or unclear ❖ Provincial or sub-national sample used | High | ||
6. | Data quality | ❖ Data provide enough information for the study | Low |
❖ Insufficient data provided or unclear | High |
Summary measures
Synthesis of results
Results
Study selection
Characteristics of the included studies
Maternal mortality
No. | Author (year) | Duration covered | Data source/type | Definitive data source | Design | Estimation method |
---|---|---|---|---|---|---|
1. | Dorrington et al., 2016 [45] | 2008–2013 | Empirical data | Vital registration | Vital registration | Direct estimation |
2. | WHO, 2015 [35] | 1990–2015 | Modelling | WHO | Modelling | Bayesian maternal mortality estimation model |
3. | MDG/Stats SA, 2015 [46] | 1998–2013 | Empirical data | Vital registration | Vital registration | Direct estimation |
4. | Dorrington et al., 2015 [47] | 2011–2014 | Empirical data | Vital registration | Vital registration | Direct estimation |
5. | WHO, 2014 [36] | 1990–2013 | Modelling | WHO | Modelling | Multilevel-regression model |
6. | Kassebaum et al., 2014 [37] | 1990–2013 | Modelling | IHME | Modelling | Cause of Death Ensemble model (CODEm) |
7. | Department of Health, 2014 [48] | 2005–2014 | Empirical data | CEMD | Active surveillance | Direct estimation |
8. | NCCEMD, 2014 [49] | 2011–2013 | Empirical data | CEMD | Active surveillance | Direct estimation |
9. | Udjo, 2014 [38] | 2001–2007 | Modelling | Model A | Modelling | Growth Balance method + Relation Gompertz model |
10. | Pattinson et al., 2013 [67] | 1999–2012 | Empirical data | CEMD | Active surveillance | Direct estimation |
11. | WHO, 2012 [39] | 1990–2010 | Modelling | WHO | Modelling | Multilevel-regression model |
12. | NCCEMD, 2012 [28] | 2008–2010 | Empirical data | CEMD | Active surveillance | Direct estimation |
13. | Garenne, 2011 [65] | 2007 | Modelling | Model B | Population-based survey | Linear logistic model |
14. | WHO, 2011 [40] | 1990–2009 | Modelling | WHO | Modelling | Bayesian maternal mortality estimation model |
15. | Lozano et al., 2011 [41] | 1990–2011 | Modelling | IHME | Modelling | Cause of Death Ensemble model (CODEm) |
16. | Stats SA, 2011 [50] | 2008–2009 | Empirical data | Vital registration | Vital registration/census | Direct estimation |
17. | WHO, 2010 [42] | 1990–2008 | Modelling | WHO | Modelling | Multilevel-regression model |
18. | Hogan et al., 2010 [43] | 1980–2008 | Modelling | IHME | Modelling | Generalised negative binomial regression |
19. | NCCEMD, 2008 [51] | 2005–2007 | Empirical data | CEMD | Active surveillance | Direct estimation |
20. | Garenne et al., 2008 [52] | 2001 | Census | Census | Census | Direct estimation |
21. | Moodley, 2003 [53] | 1999–2001 | Empirical data | CEMD | Active surveillance | Direct estimation |
22. | AbouZahr et al., 2001 [44] | 2000 | Modelling | WHO | Modelling | Robust regression |
23. | Hill et al., 2001 [66] | 1995 | Modelling | Model C | Modelling | Robust regression |
24. | Moodley, 2000 [54] | 1999 | Empirical data | CEMD | Active surveillance | Direct estimation |
25. | SADHS, 1998 [55] | 1992–1998 | Empirical data | DHS | Population-based survey | Direct sisterhood |
Neonatal mortality
No. | Author (year) | Duration covered | Data source/type | Definitive data source | Design | Estimation method |
---|---|---|---|---|---|---|
1. | SADHS, 2016 [56] | 2011–2016 | Empirical data | DHS | Population-based survey | Direct estimation |
2. | Dorrington et al., 2016 [45] | 2012–2015 | Empirical data | Vital registration | Vital registration | Direct estimation |
3. | UNICEF, 2015 [14] | 1990–2015 | Modelling | UNICEF | Modelling | Bayesian hierarchical splines regression |
4. | UNICEF, 2014 [61] | 1990–2013 | Modelling | UNICEF | Modelling | Bayesian hierarchical splines regression |
5. | Dorrington et al., 2014 [57] | 2009–2013 | Empirical data | Vital registration | Vital registration | Direct estimation |
6. | Pattinson et al., 2014 [23] | 2012–2013 | Empirical data | Vital registration | Vital registration | Direct estimation |
7. | NaPeMMCO, 2014 [58] | 2010–2013 | Empirical data | PPIP | Active surveillance | Direct estimation |
8. | WHO, 2011 [40] | 1990–2009 | Modelling | WHO | Modelling | Bayesian B-splines bias-adjusted model |
9. | Oestergaard et al., 2011 [62] | 1990–2009 | Modelling | Model A | Modelling | Multilevel-regression model |
10. | NaPeMMCO, 2011 [59] | 1997–2008 | Empirical data | PPIP | Active surveillance | Direct estimation |
11. | Rajaratnam et al., 2010 [63] | 1970–2010 | Modelling | Model B | Modelling | Gaussian process regression |
12. | SADHS, 2007 [60] | 1998–2003 | Empirical data | DHS | Population-based survey | Direct estimation |
13. | Hyder et al., 2003 [64] | 1995 | Modelling | Model C | Modelling | UN projections |
14. | SADHS, 1998 [55] | 1988–1998 | Empirical data | DHS | Population-based survey | Direct estimation |
Risk of bias within studies
No. | Author (year) | Definition | Ascertainment of deaths/live births | Sampling technique/design | Data quality | Overall risk of bias |
---|---|---|---|---|---|---|
Maternal mortality | ||||||
1. | Dorrington et al., 2016 [45] | Low | Low | Low | Low | Low |
2. | WHO, 2015 [35] | Low | Low | Low | Low | Low |
3. | MDG/Stats SA, 2015 [46] | Low | Low | Low | Low | Low |
4. | Dorrington et al., 2015 [47] | Low | Low | Low | Low | Low |
5. | WHO, 2014 [36] | Low | Low | Low | Low | Low |
6. | Kassebaum et al., 2014 [37] | Low | Low | Low | Low | Low |
7. | Department of Health, 2014 [48] | Low | High | Low | Low | High |
8. | NCCEMD, 2014 [49] | Low | High | Low | Low | High |
9. | Udjo, 2014 [38] | Low | Low | Low | Low | Low |
10. | Pattinson et al., 2013 [67] | Low | High | Low | Low | High |
11. | WHO, 2012 [39] | Low | Low | Low | Low | Low |
12. | NCCEMD, 2012 [28] | Low | High | Low | Low | High |
13. | Garenne, 2011 [65] | High | Low | Low | Low | High |
14. | WHO, 2011 [40] | Low | Low | Low | Low | Low |
15. | Lozano et al., 2011 [41] | Low | Low | Low | Low | Low |
16. | Stats SA, 2011 [50] | Low | Low | Low | Low | Low |
17. | WHO, 2010 [42] | Low | Low | Low | Low | Low |
18. | Hogan et al., 2010 [43] | Low | Low | Low | Low | Low |
19. | NCCEMD, 2008 [51] | Low | High | Low | Low | High |
20. | Garenne et al., 2008 [52] | High | Low | Low | Low | High |
21. | Moodley, 2003 [53] | Low | High | High | Low | High |
22. | AbouZahr et al., 2001 [44] | Low | Low | Low | Low | Low |
23. | Hill et al., 2001 [66] | High | Low | Low | Low | High |
24. | Moodley, 2000 [54] | Low | High | Low | Low | High |
25. | SADHS, 1998 [55] | Low | High | Low | Low | High |
Neonatal mortality | ||||||
1. | SADHS, 2016 [56] | Low | High | Low | Low | High |
2. | Dorrington et al., 2016 [45] | Low | Low | Low | Low | Low |
3. | UNICEF, 2015 [14] | Low | Low | Low | Low | Low |
4. | UNICEF, 2014 [61] | Low | Low | Low | Low | Low |
5. | Dorrington et al., 2014 [57] | Low | Low | Low | Low | Low |
6. | Pattinson et al., 2014 [23] | Low | High | Low | Low | High |
7. | NaPeMMCO, 2014 [58] | Low | Low | Low | Low | Low |
8. | WHO, 2011 [40] | Low | High | Low | Low | High |
9. | Oestergaard et al., 2011 [62] | Low | High | Low | Low | High |
10. | NaPeMMCO, 2011 [59] | Low | Low | Low | Low | Low |
11. | Rajaratnam et al., 2010 [63] | Low | Low | Low | Low | Low |
12. | SADHS, 2007 [60] | Low | High | Low | Low | High |
13. | Hyder et al., 2003 [64] | Low | High | Low | Low | High |
14. | SADHS, 1998 [55] | Low | High | Low | Low | High |