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Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5

On April 12, the Lancet published “Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5.” We encourage you to read this article and participate in subsequent discussions on this critical issue.

AMDD’s response? First and foremost, a decline in maternal deaths worldwide is welcome news. The indicators show progress and we believe that progress needs – and deserves – recognition and continued support and funding.

At AMDD, we work with many partners in support of the basic human right of all women to survive pregnancy and childbirth, and we must continue our work to realize that right for every woman, everywhere.

We know that in order to deliver the kind of quality care that saves lives, we need strong health systems that provide an integrated platform for the key pillars known to reduce maternal deaths. These include the provision of family planning, skilled birth attendance, access to emergency obstetric care and, in the context of high HIV prevalence, access to HIV/AIDS care and treatment. Robust health systems that can comprehensively address the needs of all women are at the very core of reducing maternal death and disability. 

Indeed, this study helps to focus global attention on those countries where such systems do not exist and where maternal mortality ratios remain unacceptably high. It also demonstrates that understanding country-specific contexts – a key focus for AMDD – matters in terms of sharpening our efforts and saving lives. But the study gives us only national averages. We know that very often these averages disguise deep inequity, with poor and marginalized populations suffering maternal mortality at rates far higher than the national average.

So we cannot celebrate prematurely – many women still needlessly suffer and ultimately die from entirely treatable complications of pregnancy and childbirth. Our own research confirms that in many sub-Saharan African countries, some 60-90% of women with direct obstetric complications still do not receive the life-saving emergency obstetric services they need.

So while this study points to the important progress that has been made to date, let us refocus on those women whose lives – and deaths – comprise the flip side of these statistics. There is still much work to be done.