High maternal mortality in African countries has often been linked to the practice of male dominance (patriarchy) or gender inequality. This study aimed to examine how gender inequality or patriarchy plays out in maternal mortality. A comprehensive literature search was conducted on Google Scholar database. Findings indicated that several cultural practices in African countries have had unfavorable effects on maternal health. Women were victims of injustice in cultural practices because of their relative lack of decision-making power which adversely affects maternal health seeking behaviors. Some women were denied adequate family planning use because of lack of decision-making power and non-approval of contraceptive use by some men. All these expose women to the risk of maternal mortality from high parity. Gender-based violence during pregnancy such as wife beating was also reported to be common because of the low status of women and inadequate legal protection. Also, the traditional views on the roles of women as primary caregivers limit their access to productive land assets and training as well as education. Thus, many women have little or no control over financial resources. This often limits women’s possibility to seek maternal health care which in turn contributes to high maternal mortality. The maternal death rate remains high because the cross-cutting issue, gender, in maternal mortality has not yet been addressed. Gender is a cross-cutting issue in maternal mortality because it matters in all the three major non-biomedical (socio-cultural, economic, and political) factors that contribute to high maternal mortality.
