Eliminating preventable HIV-related maternal mortality in sub-Saharan Africa: what do we need to know?

J Acquir Immune Defic Syndr. 2014 Dec 1;67 Suppl 4(Suppl 4):S250-8. doi: 10.1097/QAI.0000000000000377.

Abstract

Introduction: HIV makes a significant contribution to maternal mortality, and women living in sub-Saharan Africa are most affected. International commitments to eliminate preventable maternal mortality and reduce HIV-related deaths among pregnant and postpartum women by 50% will not be achieved without a better understanding of the links between HIV and poor maternal health outcomes and improved health services for the care of women living with HIV (WLWH) during pregnancy, childbirth, and postpartum.

Methods: This article summarizes priorities for research and evaluation identified through consultation with 30 international researchers and policymakers with experience in maternal health and HIV in sub-Saharan Africa and a review of the published literature.

Results: Priorities for improving the evidence about effective interventions to reduce maternal mortality and improve maternal health among WLWH include better quality data about causes of maternal death among WLWH, enhanced and harmonized program monitoring, and research and evaluation that contributes to improving: (1) clinical management of pregnant and postpartum WLWH, including assessment of the impact of expanded antiretroviral therapy on maternal mortality and morbidity, (2) integrated service delivery models, and (3) interventions to create an enabling social environment for women to begin and remain in care.

Conclusions: As the global community evaluates progress and prepares for new maternal mortality and HIV targets, addressing the needs of WLWH must be a priority now and after 2015. Research and evaluation on maternal health and HIV can increase collaboration on these 2 global priorities, strengthen political constituencies and communities of practice, and accelerate progress toward achievement of goals in both areas.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara
  • Anti-HIV Agents / therapeutic use*
  • Cause of Death
  • Child
  • Child, Preschool
  • Delivery of Health Care, Integrated / organization & administration*
  • Developing Countries
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / mortality*
  • Health Policy / trends*
  • Humans
  • Infant
  • Infant, Newborn
  • Maternal Health Services / organization & administration*
  • Maternal Mortality*
  • Middle Aged
  • Postpartum Period
  • Pregnancy
  • United States
  • Young Adult

Substances

  • Anti-HIV Agents