MDG 5: Reducing Maternal Mortality

In April, The New York Times reported that a Lancet study on global maternal mortality—deaths resulting from the complications of pregnancy or childbirth—had caught the international community by surprise. Looking at new data, researchers from the University of Washington and the University of Queensland found that maternal mortality had declined far more than previously estimated—from 526,300 deaths in 1980 to 342,900 in 2008.

Maternal Health  /  With the right interventions and resources, maternal mortality can be reduced dramatically.

A couple days ago, on September 15—just ahead of next week’s Millennium Development Goals Summit—the World Health Organization, UNICEF, the World Bank, and the U.N. Population Fund released their own updated analysis, which reinforced this new information. Their study found that since 1990, maternal mortality has declined by 34 percent, from 546,000 in 1990 to 358,000 in 2008. Putting the two studies together, it is clear that since 1990 the world has made much more progress in reducing maternal mortality.

Reasons for this progress include increased family incomes that allow for better, lower pregnancy rates, increased education among girls, and better access to healthcare. That’s the good news.

The bad news is that the international community is not on track to achieve the fifth Millennium Development Goal (MDG), to reduce by three-quarters the maternal mortality ratio. According to the World Health Organization/UNICEF analysis, the annual rate of decline in maternal mortality, even with the gains since 1990, is half what it should be—2.3 percent instead of the 5.5 percent that is needed.

The 2010 Millennium Development Goals Report indicates that half of all maternal deaths in developing countries are a result of hemorrhage and hypertension. Indirect causes such as HIV/AIDS, malaria, and heart disease account for 18 percent of maternal deaths.

According to the report, a vast majority of these deaths could be avoided with the help of skilled healthcare providers. But less than half the childbirths in South Asia and sub-Saharan Africa are attended by skilled healthcare attendants. Unsurprisingly, the report points out the huge disparities between rich and poor communities in developing countries in accessing health care, especially in South Asia and sub-Saharan Africa. In these regions, the richest women are five and three times more likely, respectively, to have access to a trained healthcare attendant.

There are also big urban-rural disparities. Only 33 percent of rural women have access to the recommended care in developing countries. In South Asia, that figure drops to 25 percent of rural women.

Education also plays a big role. Women with a secondary education are more likely to delay and space pregnancies, which substantially improve their chances of survival.

There are reasons for hope. The Lancet and WHO/UNICEF studies suggest that progress is possible. With the right interventions and resources, maternal mortality can be dramatically reduced. At the 2010 G8 Summit in Muskoka, Canada, on June 25-26, leaders launched the “Muskoka Initiative,” an effort that will invest $5 billion over five years in maternal and child health, focusing on MDG 4 (child mortality) and MDG 5 (maternal health).

The Obama administration has also launched the Global Health Initiative (GHI), which complements the Muskoka Initiative’s focus on strengthening health systems and on reaching women and girls. It is a new approach that builds on existing successes in the area of HIV/AIDS through the PEPFAR program. The GHI aims to help developing countries build healthcare networks that can focus on the prevention and treatment of specific diseases, but also on addressing crosscutting issues such as malnutrition and risks associated with pregnancy and childbirth.