Although some parts of the world have seen progress in maternal mortality, rates in sub-Saharan Africa are likely to make it such that the Millennium Development Goal 5 (MDG5) on improving maternal health will not be met, according to a report in The Lancet, Women Deliver special issue.
Professor Ken Hill, Harvard Center for Population and Development Studies, Cambridge, MA, USA,and gathered data from a range of sources and used a wide array of methods to produce comparable country, regional and global maternal mortality ratios for the year 2005, as well as assessing trends during the period 1990-2005.
The writers estimate that in 2005 there were 535,900 maternal deaths – a maternal mortality ratio of 402 deaths per 100,000 live births. 50% of these deaths took place in sub-Saharan Africa (270,500), and 45% in Asia (240,600). Maternal mortality rates ranged from 1 maternal death per 100,000 live births in the Republic of Ireland to 2,100 maternal deaths per 100,000 live births in Sierra Leone.
“This huge difference in risk dwarfs differences for other commonly used health indicators, such as the infant mortality rate, and makes it likely that effective interventions to reduce maternal mortality exist but are not being widely implemented,” the researchers explain.
According to the researchers, the global decline in maternal mortality ratios has been at a snail’s pace – under 1% annually between 1990 and 2005. Latin America, the Caribbean, North Africa, East and South East Asia experienced much faster declines. Figures for sub-Saharan Africa during the same period are of “great concern” – there was a decline, but a tiny one.
“In the context of MDG5, progress is slow. The yearly rate of decline required to achieve the MDG5 target of reducing national maternal mortality ratios by three-quarters between 1990 and 2015 is 5•5%, far faster than the 2•5% decrease per year estimated for the countries with data or even the 4.6% fall estimated for upper-middle income countries,” the researchers wrote.
“To achieve MDG5 targets by 2015 will need a huge and urgent emphasis on improved pregnancy and delivery care throughout the developing world. Identifying progress by 2015 will also require a major investment in data availability and data quality,” they concluded.
Accompanying Comment
Abdo Yazbeck, World Bank Institute, World Bank, Washington, DC, USA, writes about how difficult it is to measure maternal mortality and offers some possible solutions for solving this. “But the difficulty in coming up with the estimates of maternal mortality shows how far we are in many countries, from having national health systems that can measure problems, much less solve them,” Yazbeck writes.
Maternal mortality is defined as the death of a woman during pregnancy or in the 42 days following birth due to causes directly or indirectly associated with the pregnancy.
The Women Deliver Conference – October 18-20
The maternal health of women is crucial for families to survive, for economies to thrive, and cuts to the very heart of our society. The aim of The Women Deliver Conference is to focus global attention on the investment needed to save the lives and improve the health of women, mothers and newborns globally.
These issues, as well as pregnancy complications and induced abortion rates are all discussed in depth at the Women Deliver special issue of The Lancet.
Written by: Christian Nordqvist