A study published in The Lancet this week reports that maternal mortality has declined significantly for the first time in decades. The study, supported by the Bill & Melinda Gates Foundation and conducted by researchers at the University of Washington in Seattle and the University of Queensland in Brisbane, found that the number of women who died during pregnancy annually fell to an estimated 342,900 (uncertainty interval 302,100—394,300) in 2008 from 526,300 (446,400—629,600) in 1980, representing a 1.3 (1.0—1.5) percent drop in maternal deaths each year since 1990. These findings come after years of no perceived progress.
The divide between these estimates and those reported earlier by the UN (which still estimates around half a million maternal deaths annually, but is expected to release new data later this year), underscores the need for better development statistics and consistent measurement methodologies. When we have accurate statistics, we can effectively target interventions and tailor our approach to priority areas.
Despite the wide uncertainty intervals surrounding the numbers, the message of progress is clear. The study credits a number of factors for the drop in maternal mortality, including lower birth rates, increased educational attainment for women, higher incomes, and better care during delivery.
Six countries were found to account for over half of all maternal deaths: India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of Congo. Additional, targeted efforts are needed in these priority areas.
This study also emphasizes the link between HIV/AIDS and maternal and child health, finding that one in every five maternal deaths in 2008 was related to HIV. In the absence of HIV, annual maternal mortality would have dropped to 281,500 in 2008, supporting arguments for the increased integration of maternal and child survival programs into mechanisms like the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Some countries showed an unexpected increase in maternal mortality, partially attributed to better reporting, such as the U.S., Canada and Norway.
These new data should drive accelerated efforts to use proven interventions to save the lives of mothers around the world. The study should also call attention to the importance of better development statistics to target interventions, and the need for those interventions to reflect the integrated nature of health issues on the ground.