The number of women dying due to complications during pregnancy and childbirth has decreased by 34% 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.
Despite this notable progress, 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 (the number of deaths per 100,000 live births) by 75% between 1990 and 2015. This will require an annual decline of 5.5%: the current average annual decline of just 2.3%.
"The global reduction in maternal death rates is encouraging news," says Dr Margaret Chan, the Director-General of WHO.”No woman should die due to inadequate access to family planning and to pregnancy and delivery care."
For nations with high HIV prevalence, AIDS has become a leading cause of death during pregnancy and after the birth. There is also some evidence that women living with HIV are at greater risk of maternal death. Overall, it was estimated that there were 42 000 deaths due to AIDS among pregnant women globally in 2008. About half of those are estimated to be maternal. The contribution of HIV was highest in sub-Saharan Africa where 9% of all maternal deaths were AIDS-related.
“Integrating HIV services with maternal and sexual and reproductive health services is imperative to stop mothers from dying and babies from being born with HIV,” said Mr Michel Sidibé, UNAIDS Executive Director. “The AIDS movement must be leveraged to achieve reductions in maternal and child mortality.
According to the report pregnant women 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, more than half in sub-Saharan Africa. The risk of a woman in a low-income country dying from a pregnancy- related cause during her lifetime is about 35 times greater than a woman living in a high-income country.
"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 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.
UN agencies, donors and other partners have increasingly coordinated their assistance to countries, focusing on those with the greatest burden.
According to Tamar Manuelyan Atinc, Vice President for Human Development at the World Bank, “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.
