Millennium development target on maternal mortality unlikely to be met

October 11, 2007

Continuing high rates of maternal mortality* in sub-Saharan Africa are offsetting progress made in other world regions. As a result, rates of maternal mortality are not decreasing fast enough to meet the target of Millennium Development Goal 5 (MDG5) on improving maternal health . These are the conclusions of authors of an Article in this week’s Women Deliver Special Issue of The Lancet.

Professor Ken Hill, Harvard Center for Population and Development Studies, Cambridge, MA, USA and colleagues developed and used a range of methods, depending on data availability and quality, to produce comparable country, regional, and global maternal mortality ratios for 2005 and to assess trends between 1990 and 2005.

The researchers estimated that there were 535 900 maternal deaths in 2005, corresponding to a maternal mortality ratio of 402 deaths per 100000 live births. Most of these were concentrated in sub-Saharan Africa (270500, 50%) and Asia (240600, 45%). Figures for individual countries varied enormously, from a low of one maternal death per 100000 live births in Ireland, to a high of 2100 maternal deaths per 100000 live births in Sierra Leone**.

The authors say: "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."

Overall, the authors found evidence of only a very slow decline, less than 1% per year, in the maternal mortality ratio between 1990 and 2005. However, in East and South East Asia, Latin America, and the Carribean, and North Africa, there were significantly faster declines. There was only a very slight reduction in maternal mortality in sub-Saharan Africa in the same period, which the authors say is of "great concern".

The authors say: "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."

They conclude: "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."

In an accompanying Comment, Abdo Yazbeck, World Bank Institute, World Bank, Washington, DC, USA, discusses the difficulties in accurately measuring maternal mortality and possible solutions for solving this. He concludes: "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."
The paper associated with this release can be viewed at the link below:

Full contacts

Professor Ken Hill, Harvard Center for Population and Development Studies, Cambridge, MA, USA T) +1 603-253-6470 E)

Dr Carla AbouZahr, World Health Organisation, Switzerland, contact by e-mail only due to travelling commitments E)

Abdo Yazbeck, World Bank Institute, World Bank, Washington, DC, USA, T) 1-202-473-0847 E)


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