Posted by: Home Strange Home | April 17, 2010

Good news for maternal health worldwide, but a mixed bag for Africa

Millennium Development Goal number five is to reduce the maternal mortality ratio by 75% from 1990 to 2015.  A recent publication by Margaret Hogan et. al. in the medical journal The Lancet (12 April 2010) suggests that significant progress has been made towards this goal.  

Maternal mortality is measured as the number of women who die in pregnancy and childbirth per 100,000 live births.  Sub-Saharan Africa (SSA) is the region with the highest maternal mortality ratio (MMR).  There is significant variation across countries, but the aggregate figure for the region is 920 deaths per 100,000 lives births.  SSA is followed by South Asia, where the MMR is 500.  (As a point of comparison, the MMR in most developed countries is around 8).  About 34% of these maternal deaths in SSA are caused by hemorrhage.  

The Hogan et. al. study examines trends in maternal mortality from 1980 to 2008 across 181 countries.  They find a 35% drop in maternal mortality from 526,300 deaths in 1980 to 342,900 deaths in 2008.  In proportionate terms, this represents progress from 422 deaths per 100,000 live births worldwide in 1980 down to 320 in 1990 and 251 in 2008.  The researchers attribute these advances to higher incomes (leading to improved nutrition and health care access), better education for women, and greater availability of people with medical training to assist with birth.  

How does Africa fare in this good news?  The truth is that much of the progress is driven by India and China.  Progress was varied across countries.  Most of the African countries that had substantial improvements are in North Africa (Morocco, Algeria, Tunisia, Libya, and Egypt).  Meanwhile a number of African countries saw increases in maternal mortality rates over the period (e.g. South Africa, Zimbabwe, Botswana, Namibia, Mozambique, Malawi, Cameroon, Nigeria, and Cote d’Ivoire).  Surprisingly, the US was also one of the countries with an increase in maternal mortality. 

HIV/AIDS was blamed a significant cause of maternal deaths, particularly in East and Southern Africa, and the need for HIV management for pregnant women was highlighted. 


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