# Implementation Strategies for Maternal Near-Miss Case Reviews in LICs and LMICs:  A scoping review protocol

## TL;DR

This paper outlines a scoping review protocol to explore strategies for implementing maternal near-miss case reviews in low and lower-middle-income countries to reduce maternal mortality.

## Contribution

The study introduces a systematic approach to identify and characterize implementation strategies for near-miss case reviews in resource-limited settings.

## Key findings

- The review will use Arksey and O’Malley’s framework to map implementation strategies for maternal near-miss case reviews.
- Findings will inform interventions to reduce maternal mortality in low and lower-middle-income countries.
- The study will synthesize strategies from multiple databases and use tools like Rayyan and Google Sheets for screening and data extraction.

## Abstract

Maternal mortality remains a persistent public health concern despite significant strides in reduction over the past few decades, with a global maternal mortality ratio (MMR) of 223 deaths per 100,000 live births in 2020, indicating a 34.3% decline over 20 years, with Low income countries (LICs) and Lower Middle-Income Countries (LMICs) bearing the major burden. Effective implementation of facility-based near-miss case reviews (NMCR), endorsed by the World Health Organization (WHO), faces challenges hindering progress, making exploring implementation strategies through a scoping review essential. This scoping review aims to identify and characterize implementation strategies employed in Low and Lower Middle- Income Countries to facilitate the implementation of facility-based NMCR.

The scoping review will follow Arksey and O’Malley’s methodological framework, involving five stages: identifying the research question, selecting relevant studies, selecting data, charting, and summarizing the results. Electronic databases like PubMed, Embase, Web of Science, EBSCOhost - CINAHL Ultimate, and Ovid MEDLINE will be searched, supplemented by citation tracking. Rayyan will be used to screen and remove duplicates, with data charting conducted using Google Sheets. Two independent reviewers will conduct blinded screening, eligibility assessment, and inclusion phases. Reviewers will conduct Systematic data extraction independently using piloted forms, with discrepancies resolved through team discussion and consensus.

The review will identify and characterize implementation strategies employed to facilitate the implementation of facility-based near-miss case reviews in LICs and LMICs.

The findings of this review will contribute to the understanding of implementing strategies for facility-based NMCR in LICs and LMICs. The review can help in designing interventions/programs to reduce
maternal mortality and knowledge products.