A systematic review approach was adopted, in which data was searched in MEDLINE, CINAHL, web of science and global health. Relevant articles were extracted and synthesised using a narrative synthesis approach. It was identified that poor transportation system, lack of quality health care system, poor attitude of health staff toward labouring women, lack of awareness about maternal services due to poor sensitisation and belief in traditional medicine were the major challenges that led to the failure to reduce maternal mortality with respect to MDGs. It is thus concluded that these challenges be addressed in order to reduce maternal mortality in Africa read more..