INTRODUCTION:
Maternal mortality remains high in Sub-Saharan Africa (SSA), where access to antenatal care (ANC), intrapartum care (IPC), and postnatal care (PNC) is often limited. While many studies examine these services individually, little is known about their combined impact on maternal mortality. This review synthesizes evidence on how accessibility to ANC, IPC, and PNC influenced maternal mortality in SSA from 2010 to 2020.

METHODS:
A systematic search was conducted in PubMed, ProQuest, DOAJ, Global Health, Scopus, and CINAHL using predefined Boolean search strings. Peer-reviewed studies published between 2010 and 2020, reporting data from women aged 15–49 in SSA, and examining maternal health service accessibility and maternal mortality were included. Articles were screened and appraised using the CRAAP framework. A thematic analysis approach was used to synthesize findings.

RESULTS:
Thirty-seven studies met the inclusion criteria. Improved accessibility and quality of ANC showed the strongest association with reduced maternal mortality, with reductions ranging from 15% to 50% across several countries. Timely initiation and completion of recommended ANC visits consistently lowered mortality risks, while delayed or inadequate ANC increased them. Improved IPC, particularly skilled birth attendance reduced maternal mortality by 4% to 10%, but rural coverage remained low. Enhanced PNC access reduced deaths from postpartum hemorrhage, sepsis, and renal failure, though utilization remained suboptimal. Strengthened health systems, increased skilled personnel, and reduced financial barriers were common enablers of improved outcomes.

CONCLUSIONS:
Accessibility to maternal health services significantly reduces maternal mortality in SSA, with ANC demonstrating the greatest impact. Strengthening continuity and quality of care across ANC, IPC, and PNC, alongside addressing persistent systemic and socio-cultural barriers, is essential for accelerating progress in reducing maternal mortality.