Effectiveness of Nursing Interventions in Reducing Maternal Mortality in Resource-Limited Settings: A Systematic Review and Meta-Analysis.

Only three studies could be meta-analysed, and only for antenatal care with four or more visits; maternal mortality, facility delivery and morbidity were synthesized narratively. Mortality was often embedded in composite outcomes, so the review cannot show that nursing or midwifery interventions reduced maternal death specifically. The interventions were multi-component bundles involving nurses, midwives, community health workers, education, training, referral systems and facility changes, so the contribution of any single component cannot be separated. Risk of bias was not uniformly low: three studies were low risk, three moderate and two high. Definitions and measurement of outcomes varied across studies, limiting direct comparability. Some included studies had methodological concerns such as lack of blinding or unclear allocation methods. Publication bias could not be reliably assessed because only three studies were included in the meta-analysis. The review included only English-language studies and excluded studies that did not report maternal mortality or predefined secondary outcomes.

Do not conclude that nurse-led care reduces maternal mortality. The primary outcome was not meta-analysed, and the strongest mortality-related result was a composite that also included severe postpartum hemorrhage and laparotomy, so maternal death alone was not isolated.