Table 2.

Summary of reported barriers and enabling factors

Barriers	Article reference	Enabling factors	Article reference
Transport and referral
Mismanagement by referring provider	[23, 25, 26, 32–38, 44–46, 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	[25–29, 39–43, 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	[27–29]
Teamwork	[26, 53]	Emergency treatment before requiring payment	[47]
Lack of planning for organisational change	[32, 53]