The effect of maternity waiting homes on perinatal mortality is inconclusive: a critical appraisal of existing evidence from Sub-Saharan Africa
Abstract Objectives To assess the appropriateness of the statistical methodology used in a recent meta-analysis investigating the effect of maternity waiting homes (MWHs) on perinatal mortality in Sub-Saharan Africa. Results A recent meta-analysis published in BMC Research Notes used a fixed-effect...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Research Notes |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13104-021-05501-2 |
| _version_ | 1818615267579658240 |
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| author | Jaameeta Kurji Kristy Hackett Kayli Wild Zohra Lassi |
| author_facet | Jaameeta Kurji Kristy Hackett Kayli Wild Zohra Lassi |
| author_sort | Jaameeta Kurji |
| collection | DOAJ |
| description | Abstract Objectives To assess the appropriateness of the statistical methodology used in a recent meta-analysis investigating the effect of maternity waiting homes (MWHs) on perinatal mortality in Sub-Saharan Africa. Results A recent meta-analysis published in BMC Research Notes used a fixed-effect model to generate an unadjusted summary estimate of the effectiveness of MWHs in reducing perinatal mortality in Africa using ten observational studies (pooled odds ratio 0.15, 95% confidence interval 0.14–0.17). The authors concluded that MWHs reduce perinatal mortality by over 80% and should be incorporated into routine maternal health care services. In the present article, we illustrate that due to the contextual and methodological heterogeneity present in existing studies, the authors’ conclusions about the effectiveness of MWHs in reducing perinatal mortality were likely overstated. Additionally, we argue that because of the selection bias and confounding inherent in observational studies, unadjusted pooled estimates provide little causal evidence for effectiveness. Additional studies with robust designs are required before an appropriately designed meta-analysis can be conducted; until then, the ability to draw causal inferences regarding the effectiveness of MWHs in reducing perinatal mortality is limited. |
| first_indexed | 2024-12-16T16:31:12Z |
| format | Article |
| id | doaj.art-4bb8454006a7457088c6b1b9e8707bcd |
| institution | Directory Open Access Journal |
| issn | 1756-0500 |
| language | English |
| last_indexed | 2024-12-16T16:31:12Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Research Notes |
| spelling | doaj.art-4bb8454006a7457088c6b1b9e8707bcd2022-12-21T22:24:35ZengBMCBMC Research Notes1756-05002021-03-011411910.1186/s13104-021-05501-2The effect of maternity waiting homes on perinatal mortality is inconclusive: a critical appraisal of existing evidence from Sub-Saharan AfricaJaameeta Kurji0Kristy Hackett1Kayli Wild2Zohra Lassi3School of Epidemiology & Public Health, University of OttawaHarvard T.H. Chan School of Public HealthJudith Lumley Centre and Institute for Human Security & Social Change, La Trobe UniversityRobinson Research Institute, Adelaide Medical School, The University of Adelaide, Helen Mayo NorthAbstract Objectives To assess the appropriateness of the statistical methodology used in a recent meta-analysis investigating the effect of maternity waiting homes (MWHs) on perinatal mortality in Sub-Saharan Africa. Results A recent meta-analysis published in BMC Research Notes used a fixed-effect model to generate an unadjusted summary estimate of the effectiveness of MWHs in reducing perinatal mortality in Africa using ten observational studies (pooled odds ratio 0.15, 95% confidence interval 0.14–0.17). The authors concluded that MWHs reduce perinatal mortality by over 80% and should be incorporated into routine maternal health care services. In the present article, we illustrate that due to the contextual and methodological heterogeneity present in existing studies, the authors’ conclusions about the effectiveness of MWHs in reducing perinatal mortality were likely overstated. Additionally, we argue that because of the selection bias and confounding inherent in observational studies, unadjusted pooled estimates provide little causal evidence for effectiveness. Additional studies with robust designs are required before an appropriately designed meta-analysis can be conducted; until then, the ability to draw causal inferences regarding the effectiveness of MWHs in reducing perinatal mortality is limited.https://doi.org/10.1186/s13104-021-05501-2Maternity waiting homesPerinatal mortalityStillbirthsMeta-analysisSub-Saharan AfricaHeterogeneity |
| spellingShingle | Jaameeta Kurji Kristy Hackett Kayli Wild Zohra Lassi The effect of maternity waiting homes on perinatal mortality is inconclusive: a critical appraisal of existing evidence from Sub-Saharan Africa BMC Research Notes Maternity waiting homes Perinatal mortality Stillbirths Meta-analysis Sub-Saharan Africa Heterogeneity |
| title | The effect of maternity waiting homes on perinatal mortality is inconclusive: a critical appraisal of existing evidence from Sub-Saharan Africa |
| title_full | The effect of maternity waiting homes on perinatal mortality is inconclusive: a critical appraisal of existing evidence from Sub-Saharan Africa |
| title_fullStr | The effect of maternity waiting homes on perinatal mortality is inconclusive: a critical appraisal of existing evidence from Sub-Saharan Africa |
| title_full_unstemmed | The effect of maternity waiting homes on perinatal mortality is inconclusive: a critical appraisal of existing evidence from Sub-Saharan Africa |
| title_short | The effect of maternity waiting homes on perinatal mortality is inconclusive: a critical appraisal of existing evidence from Sub-Saharan Africa |
| title_sort | effect of maternity waiting homes on perinatal mortality is inconclusive a critical appraisal of existing evidence from sub saharan africa |
| topic | Maternity waiting homes Perinatal mortality Stillbirths Meta-analysis Sub-Saharan Africa Heterogeneity |
| url | https://doi.org/10.1186/s13104-021-05501-2 |
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