Systems Factors Contributing to Racial/Ethnic Disparities in Maternal Health: A Systematic Review.
Tosin B Akintunde, Myesha A Senior, Ayaba Logan et al.
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In 30 seconds
This systematic review examined hospital-level factors linked to adverse maternal outcomes and racial/ethnic disparities in the United States and Canada. Of 2,441 studies retrieved, 30 were included: 28 from the US and 2 from Canada, comprising qualitative, quantitative, and mixed-methods research. The review identified 60 factors across six health-system components. Shortages of resources, including staffing, poor care coordination, and discriminatory organizational practices were prominent factors described in the included studies. The authors conclude that addressing health-system factors alongside broader societal factors is important for reducing adverse outcomes and promoting equity.
Key findings
- The review included 30 studies: 28 conducted in the US and 2 in Canada.
- Researchers identified 60 factors: 28% related to tasks and 28% to organization.
- Staffing and other resource shortages, poor care coordination, and discriminatory organizational practices were key factors described.
Why it matters
The findings frame maternal health disparities as involving health-system conditions as well as broader societal factors. Recognising issues such as staffing shortages, coordination problems, and discriminatory organizational practices can help inform policy and quality-improvement discussions aimed at more equitable maternal care. The review maps reported factors but does not establish that any single factor causes disparities.
What to keep in mind
The evidence base was limited to 30 studies from the US and Canada, and included varied qualitative, quantitative, and mixed-methods designs.