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Maternal deaths worldwide drop by third

Report: Trends in maternal mortality
UN estimates reveal fewer women dying from pregnancy-related causes, but 1,000 still die a day and more needs to be done to achieve set targets

© UNICEF/NYHQ2006-2806/Khemka
Anita, who is eight-months pregnant, stands in the courtyard of her home in India with her children. Her youngest child is 12 months old.
GENEVA, 15 September 2010 - The number of women dying due to complications during pregnancy and childbirth has decreased by 34 per cent from an estimated 546,000 in 1990 to 358,000 in 2008, according to a new report, "Trends in maternal mortality", released by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA) and the World Bank.

The progress is notable, but the annual rate of decline is less than half of what is needed to achieve the Millennium Development Goal (MDG) target of reducing the maternal mortality ratio by 75 per cent between 1990 and 2015. This will require an annual decline of 5.5%. The 34% decline since 1990 translates into an average annual decline of just 2.3 per cent.

"The global reduction in maternal death rates is encouraging news," says Dr Margaret Chan, the Director-General of WHO. "Countries where women are facing a high risk of death during pregnancy or childbirth are taking measures that are proving effective; they are training more midwives, and strengthening hospitals and health centres to assist pregnant women. No woman should die due to inadequate access to family planning and to pregnancy and delivery care."

Pregnant women still die from four major causes: severe bleeding after childbirth, infections, hypertensive disorders, and unsafe abortion. Every day, about 1000 women died due to these complications in 2008. Out of the 1000, 570 lived in sub-Saharan Africa, 300 in South Asia and five in high-income countries. The risk of a woman in a developing country dying from a pregnancy-related cause during her lifetime is about 36 times higher compared to a woman living in a developed country.

Reaching those most at risk

"To achieve our global goal of improving maternal health and to save women's lives we need to do more to reach those who are most at risk," says Anthony Lake, Executive Director of UNICEF. "That means reaching women in rural areas and poorer households, women from ethnic minorities and indigenous groups, and women living with HIV and in conflict zones."

The new estimates show that it is possible to prevent many more women from dying. Countries need to invest in their health systems and in the quality of care. "Every birth should be safe and every pregnancy wanted, says Thoraya Ahmed Obaid, the Executive Director of UNFPA. The lack of maternal health care violates women's rights to life, health, equality, and non-discrimination. MDG5 can be achieved," she adds, "but we urgently need to address the shortage of health workers and step up funding for reproductive health services."

UN agencies, donors and other partners have increasingly coordinated their assistance to countries. WHO, UNICEF, UNFPA and the World Bank are focusing on the countries with the greatest burden and help governments to develop and align their national health plans in order to accelerate progress in maternal and newborn health.

Maternal deaths are both caused by poverty and are a cause of it. The costs of childbirth can quickly exhaust a family’s income, bringing with it even more financial hardship, says Tamar Manuelyan Atinc, Vice President for Human Development at the World Bank.

Strengthening health systems

Given the weak state of health systems in many countries, we must work closely with governments, aid donors and agencies, and other partners to strengthen these systems so that women gain significantly better access to quality family planning and other reproductive health services, skilled midwives at their births, emergency obstetric care, and postnatal care for mothers and newborns. The report that covers the period from 1990 to 2008 also highlights the following:

§ Ten out of 87 countries with maternal mortality ratios equal to or over 100 in 1990, are on track with an annual decline of 5.5 per cent between 1990 and 2008. At the other extreme, 30 made insufficient or no progress since 1990.

§ The study shows progress in sub-Saharan Africa where maternal mortality decreased by 26 per cent.

§ In Asia, the number of maternal deaths is estimated to have dropped from 315 000 to 139 000 between 1990 and 2008, a 52 per cent decrease.

§ 99 per cent of all maternal deaths in 2008 occurred in developing regions, with sub-Saharan Africa and South Asia accounting for 57% and 30% of all deaths respectively.

"We still need to do more to strengthen national data collection systems," says Dr Chan. "It is vital to support the development of complete and accurate civil registration systems that include births, deaths and causes of death. Every maternal death needs to be counted," she adds.

The UN maternal mortality estimates are developed in close collaboration with an international expert group and use all available country data on maternal mortality, as well as improved methods of estimation. The intensive country consultation carried out as part of the development of these estimates has been instrumental in identifying increased data collection efforts in recent years including the special systems to capture data on maternal deaths. There are however major gaps in the availability and quality of data for many countries where maternal mortality levels are high, and only through statistical modelling is it possible to obtain an understanding of the trend.



In 2000, 189 world leaders met at the United Nations Millennium Summit and signed onto the Millennium Declaration, agreeing to meet the Millennium Development Goals (MDGs) for the advancement of humanity and the survival of humankind. Human development, they agreed, is key to sustaining social and economic progress in all countries. The Millennium Declaration is their vision for peace and security, poverty reduction, the environment and human rights. And the MDGs, eight goals with measurable targets and clear deadlines, their road map for improving the lives of the world’s poorest people. World leaders have agreed to achieve the MDGs by 2015. The targets for the fifth goal: Improve maternal health are as follows:
1. Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio; and 2. Achieve, by 2015, universal access to reproductive health. Read more

MATERNAL HEALTH: Situation in Malaysia
Malaysia has experienced dramatic improvements in health in general, and maternal and child health in particular, throughout the post-Independence era. The maternal mortality ratio (MMR) halved between 1957 and 1970 when it fell from around 280 to 141 per 100,000 live births. By the 1990s, the MMR declined further and as of 2008, it is estimated to stand at 31 per 100,000 live birth (with an upper estimate of 68 per 100,000 live births). The lifetime risk of maternal death in Malaysia is 1 in 1,200. Malaysia’s remarkable experience in reducing maternal mortality has been the result of a synergy of a wide range of policies, strategies, and programs that have addressed access to services through socio-economic, cultural, educational, gender, and poverty dimensions. Read more

With only five years left until the 2015 deadline to achieve the Millennium Development goals, UN Secretary-General Ban Ki-moon has called on world leaders to attend a summit to accelerate progress towards the MDGs The High-level Plenary Meeting of the General Assembly will take place from 20-22 SEPT 2010 at UN Headquarters in New York. Read more





Trends in Maternal Mortality, 2010

Millennium Development Goal 5

Facts for Life


Healthy Mothers

Missing Mothers

SOWC 2009 - Maternal and Newborn Health

Countdown to 2015

UN MDG Summit 2010


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