Background: The current state of evidence on determinants, implementation approaches, and research addressing health system issues, relevant to maternal and neonatal mortality (MNM) in Indonesia, is unknown. Whereas, the clear understanding of the existing evidence is essential to inform policies and to accelerate progress in reducing the MNM in Indonesia.
Objectives: To synthesise all existing evidence and identify evidence gaps related to MNM.
Methods: A conceptual framework of the magnitude of the problem, and the methodological guideline for systematic review (SR) approach were discussed among core technical group consisting of panel of content and methodological experts. 21 focal questions (FQ) in 6 topic areas, i.e. quality of care, referral system, health financing, local governance systems, evidence utilisation, and gender equity, were developed. Maternal, neonatal, and methodological experts from all over Indonesia, were selected to form evidence review teams (ERT) to conduct the SR for each FQ. ERT developed the protocol to guide through evidence gathering and selection, quality assessment, data extraction, and evidence synthesis. The evidence was gathered from bibliographic sources, using the predefined search strategy. Hand searching for dissertations/theses, proceedings, project reports from the relevant institutions was also performed. Additionally, the relevant literatures identified by experts were collected through call for evidence. The retrieved literature was screened based on the pre-specified eligibility criteria. The risk of bias for each eligible literature will be performed using quality assessment tools from Effective Public Health Practice Project (EPHPP). The data on study characteristics and results will be extracted and reported. The meta-analyses will be done, if no heterogeneity is identified; otherwise we will synthesise the results narratively. The quality of evidence will be reported and became one of the basis for drawing a conclusion and recommendation. Afterwards, the qualitative SR will be conducted and the findings will be synthesised using thematic analyses and be used for enhancing the recommendation.