Systematic Review and Meta-Analysis: Association Between Water and Sanitation Environment and Maternal Mortality

This journal paper summarises a systematic review which assessed whether the lack of water or the lack of sanitation facilities in either the home or in health facilities was associated with an increased risk of maternal mortality and to quantify the effect sizes. It found that there is evidence of association between sanitation and maternal mortality and between water and maternal mortality. Both associations are of substantial magnitude and are maintained after adjusting for confounders. However, these conclusions are based on a very small number of studies, few of which set out to examine sanitation or water as risk factors, and only some of which adjusted for potential confounders. Nevertheless, there are plausible pathways through which such associations may operate.