{"id":"https://openalex.org/W7140813895","doi":"https://doi.org/10.1186/s12982-026-01765-w","title":"Maternal mortality and health policies in Sub-Saharan Africa insights from Nigeria Rwanda South Africa Gabon","display_name":"Maternal mortality and health policies in Sub-Saharan Africa insights from Nigeria Rwanda South Africa Gabon","publication_year":2026,"publication_date":"2026-03-26","ids":{"openalex":"https://openalex.org/W7140813895","doi":"https://doi.org/10.1186/s12982-026-01765-w"},"language":"en","primary_location":{"id":"doi:10.1186/s12982-026-01765-w","doi":"https://doi.org/10.1186/s12982-026-01765-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12982-026-01765-w","pdf_url":"https://link.springer.com/content/pdf/10.1186/s12982-026-01765-w.pdf","source":{"id":"https://openalex.org/S5407042889","display_name":"Discover Public Health","issn_l":"3005-0774","issn":["3005-0774"],"is_oa":true,"is_in_doaj":true,"is_core":false,"listed_in":["doaj","jufo-1","norway-1","russia-white-list-1","vabb-shw"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Discover Public Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://link.springer.com/content/pdf/10.1186/s12982-026-01765-w.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5130668208","display_name":"Ezinne Victory Kanu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I31959934","display_name":"Nasarawa State University","ror":"https://ror.org/04ybvje46","country_code":"NG","type":"education","lineage":["https://openalex.org/I31959934"]}],"countries":["NG"],"is_corresponding":true,"raw_author_name":"Ezinne Victory Kanu","raw_affiliation_strings":["Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria","institution_ids":["https://openalex.org/I31959934"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5125065578","display_name":"Charles Chibuisi Ehiemere","orcid":"https://orcid.org/0009-0007-6853-0226","observed_orcids":["https://orcid.org/0009-0007-6853-0226"]},"institutions":[{"id":"https://openalex.org/I31959934","display_name":"Nasarawa State University","ror":"https://ror.org/04ybvje46","country_code":"NG","type":"education","lineage":["https://openalex.org/I31959934"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Charles Chibuisi Ehiemere","raw_affiliation_strings":["Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria","institution_ids":["https://openalex.org/I31959934"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5098017738","display_name":"Ishaku Adamu Akyala","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I31959934","display_name":"Nasarawa State University","ror":"https://ror.org/04ybvje46","country_code":"NG","type":"education","lineage":["https://openalex.org/I31959934"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Ishaku Adamu Akyala","raw_affiliation_strings":["Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria","institution_ids":["https://openalex.org/I31959934"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130631294","display_name":"Eric Terkuma Chia","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I31959934","display_name":"Nasarawa State University","ror":"https://ror.org/04ybvje46","country_code":"NG","type":"education","lineage":["https://openalex.org/I31959934"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Eric Terkuma Chia","raw_affiliation_strings":["Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria","institution_ids":["https://openalex.org/I31959934"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5048910981","display_name":"Z Abubakar","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I31959934","display_name":"Nasarawa State University","ror":"https://ror.org/04ybvje46","country_code":"NG","type":"education","lineage":["https://openalex.org/I31959934"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Zakari Abubakar","raw_affiliation_strings":["Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Global Health and Infectious Diseases Control Institute, Nasarawa State University Keffi, North Central Nigeria, P.M.B 1022, Keffi, Nasarawa State, Nigeria","institution_ids":["https://openalex.org/I31959934"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5130668208"],"corresponding_institution_ids":["https://openalex.org/I31959934"],"apc_list":{"value":0,"currency":"USD","value_usd":0},"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"23","issue":"1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10209","display_name":"Global Maternal and Child Health","score":0.989300012588501,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10209","display_name":"Global Maternal and Child Health","score":0.989300012588501,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.004600000102072954,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.0015999999595806003,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/maternal-mortality","display_name":"maternal mortality","score":1.0},{"id":"https://openalex.org/keywords/maternal-health-policy","display_name":"maternal health policy","score":0.8930000066757202},{"id":"https://openalex.org/keywords/health-system-governance","display_name":"health system governance","score":0.48399999737739563},{"id":"https://openalex.org/keywords/policy-implementation","display_name":"policy implementation","score":0.621999979019165},{"id":"https://openalex.org/keywords/performance-based-funding","display_name":"performance-based funding","score":0.640999972820282},{"id":"https://openalex.org/keywords/community-health-workers","display_name":"community health workers","score":0.8920000195503235},{"id":"https://openalex.org/keywords/primary-health-care-financing","display_name":"primary health care financing","score":0.9359999895095825},{"id":"https://openalex.org/keywords/healthcare-workers","display_name":"healthcare workers","score":0.6029999852180481},{"id":"https://openalex.org/keywords/health-equity","display_name":"health equity","score":0.6359999775886536},{"id":"https://openalex.org/keywords/health-care-financing","display_name":"health care financing","score":0.47600001096725464},{"id":"https://openalex.org/keywords/sub-saharan-africa","display_name":"sub-Saharan Africa","score":0.7699999809265137},{"id":"https://openalex.org/keywords/nigeria","display_name":"Nigeria","score":0.6520000100135803},{"id":"https://openalex.org/keywords/rwanda","display_name":"Rwanda","score":1.0},{"id":"https://openalex.org/keywords/south-africa","display_name":"South Africa","score":1.0},{"id":"https://openalex.org/keywords/gabon","display_name":"Gabon","score":0.8790000081062317},{"id":"https://openalex.org/keywords/sdg-3","display_name":"Sustainable Development Goal 3","score":0.7229999899864197},{"id":"https://openalex.org/keywords/health-system-capacity","display_name":"health system capacity","score":0.5419999957084656}],"concepts":[{"id":"https://openalex.org/C2778139618","wikidata":"https://www.wikidata.org/wiki/Q13440398","display_name":"Workforce","level":2,"score":0.6711000204086304},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.5893999934196472},{"id":"https://openalex.org/C199728807","wikidata":"https://www.wikidata.org/wiki/Q2578557","display_name":"Equity (law)","level":2,"score":0.5494999885559082},{"id":"https://openalex.org/C39389867","wikidata":"https://www.wikidata.org/wiki/Q380767","display_name":"Corporate governance","level":2,"score":0.4763000011444092},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.4296000003814697},{"id":"https://openalex.org/C46299933","wikidata":"https://www.wikidata.org/wiki/Q61559","display_name":"Child mortality","level":3,"score":0.41179999709129333},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.4072999954223633},{"id":"https://openalex.org/C112299071","wikidata":"https://www.wikidata.org/wiki/Q835884","display_name":"Infant mortality","level":3,"score":0.39579999446868896},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.3953999876976013},{"id":"https://openalex.org/C2983493262","wikidata":"https://www.wikidata.org/wiki/Q6786626","display_name":"Maternal health","level":4,"score":0.38999998569488525},{"id":"https://openalex.org/C2250968","wikidata":"https://www.wikidata.org/wiki/Q1512929","display_name":"Health equity","level":3,"score":0.3831000030040741},{"id":"https://openalex.org/C46578552","wikidata":"https://www.wikidata.org/wiki/Q2725393","display_name":"Global health","level":3,"score":0.37130001187324524},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.3666999936103821},{"id":"https://openalex.org/C179755657","wikidata":"https://www.wikidata.org/wiki/Q58702","display_name":"Mortality rate","level":2,"score":0.3582000136375427},{"id":"https://openalex.org/C47768531","wikidata":"https://www.wikidata.org/wiki/Q1127188","display_name":"Development economics","level":1,"score":0.3400999903678894},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.3361000120639801},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.3181999921798706},{"id":"https://openalex.org/C83864248","wikidata":"https://www.wikidata.org/wiki/Q177323","display_name":"Developing country","level":2,"score":0.3158000111579895},{"id":"https://openalex.org/C2775951005","wikidata":"https://www.wikidata.org/wiki/Q3473024","display_name":"Community health","level":3,"score":0.31360000371932983},{"id":"https://openalex.org/C3013748606","wikidata":"https://www.wikidata.org/wiki/Q15787","display_name":"Human immunodeficiency virus (HIV)","level":2,"score":0.3084000051021576},{"id":"https://openalex.org/C45355965","wikidata":"https://www.wikidata.org/wiki/Q1643441","display_name":"Socioeconomics","level":1,"score":0.29789999127388},{"id":"https://openalex.org/C2779958979","wikidata":"https://www.wikidata.org/wiki/Q3473027","display_name":"Rural health","level":3,"score":0.2849000096321106},{"id":"https://openalex.org/C3018448503","wikidata":"https://www.wikidata.org/wiki/Q5154968","display_name":"Community health workers","level":4,"score":0.2840999960899353},{"id":"https://openalex.org/C2778137410","wikidata":"https://www.wikidata.org/wiki/Q2732820","display_name":"Government (linguistics)","level":2,"score":0.2745000123977661},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.2741999924182892},{"id":"https://openalex.org/C2986740045","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health services","level":3,"score":0.26919999718666077},{"id":"https://openalex.org/C109986646","wikidata":"https://www.wikidata.org/wiki/Q546113","display_name":"Public policy","level":2,"score":0.265500009059906},{"id":"https://openalex.org/C2779968149","wikidata":"https://www.wikidata.org/wiki/Q8034851","display_name":"Workforce development","level":3,"score":0.26339998841285706},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.2632000148296356}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1186/s12982-026-01765-w","doi":"https://doi.org/10.1186/s12982-026-01765-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12982-026-01765-w","pdf_url":"https://link.springer.com/content/pdf/10.1186/s12982-026-01765-w.pdf","source":{"id":"https://openalex.org/S5407042889","display_name":"Discover Public Health","issn_l":"3005-0774","issn":["3005-0774"],"is_oa":true,"is_in_doaj":true,"is_core":false,"listed_in":["doaj","jufo-1","norway-1","russia-white-list-1","vabb-shw"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Discover Public Health","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:7e061066ca0244d293fced8de26e1fd4","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/7e061066ca0244d293fced8de26e1fd4","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Discover Public Health, Vol 23, Iss 1 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1186/s12982-026-01765-w","doi":"https://doi.org/10.1186/s12982-026-01765-w","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12982-026-01765-w","pdf_url":"https://link.springer.com/content/pdf/10.1186/s12982-026-01765-w.pdf","source":{"id":"https://openalex.org/S5407042889","display_name":"Discover Public Health","issn_l":"3005-0774","issn":["3005-0774"],"is_oa":true,"is_in_doaj":true,"is_core":false,"listed_in":["doaj","jufo-1","norway-1","russia-white-list-1","vabb-shw"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Discover Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9476000070571899,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"},{"score":0.7578999996185303,"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities"},{"score":0.6025999784469604,"id":"https://metadata.un.org/sdg/5","display_name":"Gender equality"},{"score":0.5473999977111816,"id":"https://metadata.un.org/sdg/16","display_name":"Peace, justice, and strong institutions"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7140813895.pdf","grobid_xml":"https://content.openalex.org/works/W7140813895.grobid-xml"},"referenced_works_count":24,"referenced_works":["https://openalex.org/W2149116156","https://openalex.org/W2322081896","https://openalex.org/W2514770372","https://openalex.org/W2565884969","https://openalex.org/W2599719327","https://openalex.org/W2607111575","https://openalex.org/W2614027087","https://openalex.org/W2797020584","https://openalex.org/W2901087938","https://openalex.org/W2924587670","https://openalex.org/W2934562666","https://openalex.org/W2972383937","https://openalex.org/W2991026100","https://openalex.org/W3027979598","https://openalex.org/W3032190508","https://openalex.org/W3118484919","https://openalex.org/W3133068959","https://openalex.org/W4224986585","https://openalex.org/W4225480312","https://openalex.org/W4282931929","https://openalex.org/W4311735214","https://openalex.org/W4327744883","https://openalex.org/W4386246301","https://openalex.org/W4389192739"],"related_works":["https://openalex.org/W7167268123","https://openalex.org/W7223222214","https://openalex.org/W4402767334","https://openalex.org/W7008733480","https://openalex.org/W2954400868","https://openalex.org/W3008616722","https://openalex.org/W3177362594","https://openalex.org/W2558811589","https://openalex.org/W3127910033","https://openalex.org/W7147595718"],"abstract_inverted_index":{"Despite":[0],"global":[1],"commitments":[2],"under":[3],"SDG-3,":[4],"maternal":[5,109],"mortality":[6],"rates":[7],"remain":[8],"disproportionately":[9],"high":[10],"in":[11,27],"Sub-Saharan":[12],"Africa.":[13],"This":[14,161],"review":[15,37],"examines":[16],"how":[17],"health":[18,74,97],"policies":[19,65],"have":[20],"shaped":[21],"outcomes":[22],"between":[23],"2014":[24],"and":[25,32,46,58,73,84,95,108,123,131,153],"2024":[26],"Nigeria,":[28],"Rwanda,":[29],"South":[30,100],"Africa,":[31],"Gabon.":[33],"A":[34],"comparative":[35],"narrative":[36],"was":[38],"conducted":[39],"using":[40],"WHO,":[41],"World":[42],"Bank,":[43],"UNFPA,":[44],"DHS,":[45],"national":[47],"policy":[48,143],"documents.":[49],"Guided":[50],"by":[51],"the":[52,59],"Walt":[53],"&":[54],"Gilson":[55],"Policy":[56],"Triangle":[57],"WHO":[60],"Health":[61],"System":[62],"Building":[63],"Blocks,":[64],"were":[66,78],"assessed":[67],"for":[68,158],"context,":[69],"content,":[70],"actors,":[71],"process,":[72],"system":[75],"capacity.":[76],"Data":[77],"synthesized":[79],"thematically":[80],"to":[81,167],"compare":[82],"implementation":[83],"outcomes.":[85,127],"Rwanda":[86],"achieved":[87],"substantial":[88],"declines":[89],"through":[90],"decentralized":[91],"financing,":[92],"performance-based":[93],"funding,":[94],"community":[96,154],"worker":[98],"integration.":[99],"Africa":[101],"reduced":[102],"deaths":[103],"via":[104],"integration":[105],"of":[106],"HIV":[107],"services":[110],"but":[111,120],"still":[112],"faces":[113],"equity":[114],"gaps.":[115],"Gabon":[116],"improved":[117],"financial":[118],"access":[119],"rural":[121],"infrastructure":[122],"workforce":[124,151],"limitations":[125],"constrain":[126],"Nigeria\u2019s":[128],"fragmented":[129],"governance":[130],"weak":[132],"PHC":[133],"financing":[134,149],"explain":[135],"stagnation":[136],"despite":[137],"multiple":[138],"reforms.":[139],"Implementation":[140],"quality,":[141],"not":[142],"presence,":[144],"drives":[145],"progress.":[146],"Strengthening":[147],"governance,":[148],"transparency,":[150],"readiness,":[152],"engagement":[155],"remains":[156],"crucial":[157],"achieving":[159],"SDG-3.":[160],"study":[162],"highlights":[163],"cross-country":[164],"lessons":[165],"transferable":[166],"similar":[168],"contexts.":[169]},"counts_by_year":[],"updated_date":"2026-09-21T07:43:02.447757","created_date":"2026-03-27T00:00:00"}