Health systems interventions for prevention of maternal peripartum infection in low and middle-income countries: a systematic review.

Authors

Roseline Abwao, Job Mapesa, Wanja Tenambergen, David Odada, Nasra Gathoni, Felix Riunga

Published in

BMC women's health. Volume 26. Issue 1. Jul 23, 2026. Epub Jul 23, 2026.

Abstract

Globally, there is growing recognition that a functional health system is key to improving maternal health and reducing maternal mortality. Maternal peripartum infection remains a major cause of maternal morbidity and mortality, particularly in low- and middle-income countries. This infection is a multifaceted problem with many players. Adopting a health systems approach could help avert this preventable infection by addressing the gaps across all the components of care.
The aim of this systematic review was to identify and evaluate interventions to prevent maternal peripartum infection in LMICs.
A systematic search was conducted in Cochrane Library, CINAHL, MEDLINE (via PubMed) and Scopus, World Health Organization (WHO), and the National Institute for Health and Care Excellence (NICE) websites to identify primary articles reporting on interventions for preventing maternal peripartum infection using the PRISMA model. The article search was conducted for a period of 3 months (01/08/2022 to 30/10/2022). Search terms were "Peripartum", "Infection", "Genital tract", and their MESH terms. The inclusion criteria were primary interventional studies that reported interventions for the prevention of maternal peripartum infection, studies from LMICs, and those written in the English language. Cochrane Risk of Bias tools were used to appraise the quality of the studies.
Out of 1662 articles, 24 studies met the inclusion criteria comprising of 55,982 participants. The interventions were grouped into five domains: antibiotic prophylaxis 10(42%) of studies), self-care training 6 (25%), skin preparation 5 (21%), Traditional Birth Attendant training 2(2%) and use of Clean Delivery Kit 1(1%)0.11 studies reported a significantly lower risk of infection. Four studies reported a significantly improved knowledge and practice of women regarding maternal peripartum infection. While six studies reported no change in the risk of infection with the intervention.
A range of interventions targeting maternal peripartum infection prevention in LMICs were identified in this review. They were all targeting a single intervention without integrating other system components. The review highlights the need for integrated health systems interventions and further research to generate stronger evidence and inform effective implementation.
PROSPERO CRD42022342550.

PMID:
42902316
Bibliographic data and abstract were imported from PubMed on 21 Oct 2026.

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