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Table 2 Summary of reported barriers and enabling factors

From: Maternal death and obstetric care audits in Nigeria: a systematic review of barriers and enabling factors in the provision of emergency care

Barriers Article reference Enabling factors Article reference
Transport and referral
 Mismanagement by referring provider [23, 25, 26, 3238, 4446, 48, 57, 61]   
 Inefficient ambulance services [26, 62]   
 Lack of transport at night [30, 55]   
Health workers
 Lack of manpower [26, 28, 32, 49, 53] Frequent training for clinical procedures [27, 47]
 Unskilled health professionals [23, 26, 27, 29, 31, 35, 37, 47, 49, 50, 52, 53, 56, 58, 60]   
 Low staff morale [25, 29]   
Availability of supporting services and facilities
 Lack of operation theatres and intensive care units [26, 53] Round the clock services [26, 53]
 Lack of specialist medical equipment and services [25, 26, 42, 65] Blood banking [26, 35, 47, 51, 53, 59]
 Unavailability of essential drugs and supplies including blood and magnesium sulphate [2529, 3943, 53, 54, 63]   
 Unreliable telephone communications and power supply [26, 28, 53]   
Organisation of care
 Poor record keeping [24, 38, 45, 64, 65] Conducting maternal death reviews [2729]
 Teamwork [26, 53] Emergency treatment before requiring payment [47]
 Lack of planning for organisational change [32, 53]