Good news! Over the past 25 years the rate of maternal death has fallen by nearly a half. This comes partly as a result of a target set by the United Nations back in 2000. As a part of the Millennium Development Goals scores of countries around the world signed up to attempt to reduce maternal mortality by 75% from levels at 1990 by 2015. Whilst only 9 countries achieved that specific target, nearly every country in the world achieved an improvement. The full report is available open access in The Lancet.
The big winners were Rwanda, Maldives, Bhutan, Cambodia, Cape Verde, Timor-Leste, Iran, Laos and Mongolia all of whom met the 75% reduction target. Not everyone is going in the right direction, however; Zimbabwe, Suriname, South Africa and Guyana all saw a worsening of maternal mortality over the 25 year period. It is particularly disappointing to see South Africa in that list, a country that has had every opportunity to develop itself over the past twenty years but has taken significant steps backwards over the past 5 years or so; the Government has let the people down.
Maternal mortality, which is defined as the death of a woman whilst pregnant, or within 42 days of the end of a pregnancy, which was aggravated by the pregnancy, has traditionally always been the biggest single killer of women worldwide and so any effort to reduce it should have substantial benefits, as seems to have been the case here. In 1990 532,000 women died as a result of their pregnancy, this year it will be about 303,000. There is still a long way to go but there is plenty of low hanging fruit out there. Lots of sub-Sarharan Africa still has mortality rates that are more than double that of the rest of the world, huge gains could be made there with relatively modest improvements in healthcare and/or infrastructure.
To this end, the UN has a new goal of reducing maternal mortality from today’s rate of 216 per 100,000 live births to just 70 per 100,000 by the year 2030. This is hugely ambitious. For the past 25 years the world has been averaging about 2.5% reduction per year, to achieve this new target will require an annual reduction of some 7.5%. I sincerely hope the target is met but to do so is going to require a significant change in Africa. There’s going to need to be widespread healthcare improvements, road and hospital building, improvements in sanitation and, of course, enough food and water to go round; basic things that the people deserve but seem criminally slow in coming.