MATERNAL MORTALITY IS HIGHEST IN SUB-SAHARAN AFRICA AND SOUTH ASIA
Maternal mortality ratios per 100,000 live births, by region (2005)
A review of recent evidence shows that while a number of middle-income countries have made progress in reducing maternal deaths, less progress has been achieved in low-income countries, particularly in sub-Saharan Africa. Across the developing world, maternal mortality levels remain too high, with more than 500,000 women dying every year as a result of complications during pregnancy and childbirth. About half of these deaths occur in sub-Saharan Africa and about one third occur in South Asia – the two regions together account for about 85 per cent of all maternal deaths. In sub-Saharan Africa, a woman’s lifetime risk of maternal death is a staggering 1 in 22, compared with 1 in 8,000 in industrialized countries.
The causes of maternal death vary markedly across regions and countries. Haemorrhage is the leading cause of maternal death in sub-Saharan Africa and South Asia, while hypertensive disorders during pregnancy and labour play a more prominent role in Latin America/Caribbean. In industrialized countries, most deaths are due to other causes, including complications from anaesthesia and Caesarean sections.
Challenges to measuring maternal mortality
Maternal mortality is difficult and complex to monitor, particularly in settings where the levels of maternal deaths are highest. Information is required about deaths among women of reproductive age, their pregnancy status at or near the time of death and the medical cause of death – all of which can be difficult to measure accurately, particularly where vital registration systems are incomplete. Maternal deaths are also relatively rare events, even in high-mortality areas, and are prone to measurement error. Therefore, the World Health Organization, UNICEF, the United Nations Population Fund and the World Bank have developed an approach to adjusting these data for underreporting and misclassification and producing model-based estimates for countries that lack reliable national-level data. These estimates (for the year 2005) are presented in this statistical review.
Trend analysis over time is problematic because of the large margins of uncertainty around the estimates. Nevertheless, a recent analysis of trends in maternal mortality based on 1990 and 2005 estimates shows that maternal mortality has decreased globally, although not at the rate needed to achieve MDG 5. The analysis finds, too, that during this period little progress was made in sub-Saharan Africa, the region with the highest levels of maternal mortality.
LIFETIME RISK OF MATERNAL DEATH IS 1 IN 22 IN SUB-SAHARAN AFRICA, 1 IN 8,000 IN INDUSTRIALIZED COUNTRIES
Lifetime risk of maternal death, by region (2005)
MATERNAL MORTALITY IS HIGHEST IN COUNTRIES OF SUB-SAHARAN AFRICA AND SOUTH ASIA
Maternal mortality ratios (MMR) per 100,000 live births (2005)
HAEMORRHAGE CAUSES MORE THAN ONE THIRD OF MATERNAL DEATHS IN AFRICA
Per cent distribution of maternal deaths in Africa, by cause (1997-2002)