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Maternal Mortality: Where are we now? Where are we heading? » Women's Courage

Maternal Mortality: Where are we now? Where are we heading?

March 7th, 2013 by amanorot Leave a reply »

In my last blog post I want to look towards the future and bring the conversation about maternal mortality full circle. In my first post I introduced the United Nations Millennium Development Goal (MDG) to improve maternal health. This ambitious goal includes two targets. First, reduce the maternal mortality ratio by three quarters from 1990 to 2015 and second, by 2015 achieve universal access to reproductive health (1). I highlighted the country Laos who announced in 2009 that the country would not be able to reach the MDG target. With only two years left before 2015, where does the rest of the world stand? What is our progress and where are we heading?

At the 2013 Global MDG Conference a week ago, Helen Clark the Administrator of the UN Development Program acknowledged maternal mortality reduction and universal access to reproductive health as areas where too little progress has been made in terms of the goals and targets that were set in 2000 (2). Of the 189 nations that made this promise to women by signing the United Nations Millennium Development Goals, 181 were analyzed in a study published by The Lancet in 2010. The analysis concluded only 23 countries were on track to achieve the 75% decrease in the maternal mortality ratio by 2015 (3). This predicted outcome is disheartening and on an artificial level appears that little headway has been made for women’s reproductive health.

A closer analysis of the data shows gradual process. The global maternal death rate estimated in 2008 was 342,900 compared to 526,300 in 1980 and experts in the field agree that the maternal death rate is a third less than in the past three decades, still short of the MDG goal, but nonetheless is progress (4). The Lancet study notes global progress in the reduction seen in the maternal mortality rate is not surprising because four crucial drivers of maternal mortality are improving worldwide (3).

  • The total fertility rate has dropped significantly from 3:70 in 1980 to 2:56 in 2008 despite the growing population of women in their reproductive years.
  • Average income per person has been rising in Asia and Latin America resulting in financial opportunity for better nutrition and access to health care for mothers
  • Average educational accomplishment for women has increased from 1:5 in 1980 to 4:4 in 2008
  • The prevalence of skilled birth attendants has been steadily increasing contributing to maternal mortality decline.

An eminent supporter of women and children’s health, The Bill & Melinda Gates foundation in September 2011 announced the investment of $35 million in funding for innovative ideas in family health. The objective of the grants is to engage the world’s scientists and entrepreneurs in creating revolutionary breakthroughs for health challenges facing women and children (5). Melinda Gates recognized for her philanthropic focus in women and children’s health voiced her frustration this past January about the quality of data surrounding global health issues. She argues measurement is crucial in identifying appropriate interventions to improve maternal mortality and is necessary to set clear goals and track progress in order to make substantial improvements in the field (4). Looking towards the future and facing the prospect of poor outcomes for the MDG maternal health goal we need to develop tools that allow us to accurately track the maternal mortality rate, its causes per community, and rate the efficacy of the interventions we champion.

A new tool created by The United Nations Children’s Fund to help policymakers and community health workers understand high rates of maternal mortality is called the Maternal and Perinatal Death Inquiry and Response (MAPEDIR). Rather than recording a maternal death and as a statistic, MAPEDIR aims to sensitize communities to the health issues that lead to birth complications, provide an investigative report into maternal deaths by interviewing family members to determine biological and social causes, and analyzing the data to develop high impact social interventions (6). It is the hope that MAPEDIR will improve the data we have to access maternal mortality.

There are numerous organizations worldwide on the local, national, and global scale that focus their efforts on improving women and children’s health and in solidarity aim to reduce the maternal mortality ratio. Throughout my posts I have highlighted interventions that utilize design to increase access to emergency care, harness technology to improve health, and health policies enacted to save women the horrible fate of maternal death.

Although we have come a long way in reducing maternal mortality compared to where we were decades ago, there is still a lot to be done in order to prevent the needless deaths of women and ensure all women their right to reproductive care, autonomy over their bodies, and personal vitality.

  1. http://www.who.int/mediacentre/factsheets/fs290/en/index.html
  2. http://www.un.org/apps/news/story.asp?NewsID=44241&Cr=mdgs&Cr1=#.UTkZ1BlAtqx
  3. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2960518-1/fulltext
  4. http://www.foreignpolicy.com/articles/2013/01/30/measure_for_measure?page=0,0
  5. http://www.gatesfoundation.org/Media-Center/Press-Releases/2011/11/Foundation-Announces-$35-Million-in-Funding-for-Innovative-Ideas-in-Family-Health
  6. http://www.womendeliver.org/updates/entry/new-tool-to-track-maternal-mortality/
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3 comments

  1. KadesiaW says:

    Thank you for this post! I just explored this topic for another course. Though little progress has been made, I am still very grateful that those changes have occurred. However, I still feel that people don’t think maternal death is a huge problem, and that may be due to the fact that 99% of all maternal deaths occur outside of developed countries. In reading the UN’s 2011 Report on MDGs, I was disappointed to see that so,e countries were on their way toward the goal, but that so little has been done in Sub-Saharan Africa and South East Asia which makes up majority of the maternal death total. I am also astonished by how little is known of maternal morbidity, and results of fistulas, uterine prolapse, etc. If childbearing is the most noble job, why don’t we make improving maternal conditions for all women better? Instead of addressing the issues of facilities and health centers only, why don’t we address the needs of the patients? This was a mini-rant, but it just disappoints me that maternal mortality isn’t a hot button issue for some, even when it is so crucial to everything, starting with the health and wellness of the generation descending those mothers.

  2. Chloe says:

    Thank you for your posts on maternal mortality this quarter. I find it such a tragedy that so many women die trying to bring life into the world. It is something I did not think about as a modern problem until this class because child birth is comparatively very safe in the United States. This is just not the case for so many parts of the world. Childbirth should be a time of celebration and excitement but because it is so dangerous in many places, for many women it is a time of dread and extreme anxiety. These women know that there is a sizable probability they will be in excruciating labor for days, and following that they may not be able to walk, may no longer have control over their bladder, or may not survive. As a woman who is very much looking forward to giving birth, this disparity in our world breaks my heart.

  3. Kathryn says:

    Thanks for your post! I was especially interested in reading about the United Nations Children’s Fund MAPEDIR tool to sensitize communities and use data to develop effective interventions. I am also very interested in improving maternal health internationally, and I hope that we can continue to make significant progress in reducing maternal mortality worldwide. It sounds like you highlighted very promising interventions that show we are headed in the right direction.

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