Maternal mortality ratios

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  • Critical Care Obstetrics Preventing Maternal Morbidity & Mortality An Educational Program from the Safe Motherhood Initiative .US Maternal Mortality Today On the rise? .A Regional Look at Maternal Mortality Ratios* for the Year 2004 20.5 in all of NYS 15.9 in NYS 24.4 in NYC *per 100,000 live births HP2010 Goal 4.3 .

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  • each year some eight million of the estimated 210 million women who become pregnant, suffer life- threatening complications related to pregnancy. in 2000, an estimated 529,000 women died during pregnancy and childbirth from largely preventable causes; 2.7 million infants are stillborn every year and three million infants die within the first seven days of life. globally, the maternal mortality ratio has not changed over the past decade. Ninety-nine percent of all maternal deaths occur in developing countries16 . Somalia has one of the highest maternal mortality ratios in the world.

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  • For maternal mortality progress has been even more elusive. Despite 15 years of the Safe Motherhood Initiative, overall levels of maternal mortality are generally thought to have remained unchanged, with the latest estimate of deaths standing at approximately 530,000 per year (WHO, UNICEF et al. 2003). While a handful of countries have indeed experienced remarkable drops in maternal mortality ratio (an indicator of the safety of childbirth and pregnancy), in the great majority of high mortality countries, there has been little change.

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  • One of the eight Millennium Development Goals (MDGs) that has made some progress, albeit slow, is MDG 5: Improve maternal health. The two targets for assessing MDG 5 are reducing the maternal mortality ratio (MMR) by three quarters between 1990 and 2015, and achieving universal access to reproductive health by 2015. The United Nations (UN) Secretary-General has launched the Global strategy for women’s and children’s health, to mobilize commitments by governments, civil society organizations and development partners to accelerate progress towards MDGs 4 and 5 (1).

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  • World Development Indicators 2011, the 15th edition in its current format, aims to provide relevant, high-quality, internationally comparable statistics about development and the quality of people’s lives around the globe. This latest printed volume is one of a group of products; others include an online dataset, accessible at http://data.worldbank. org; the popular Little Data Book series; and DataFinder, a data query and charting application for mobile devices.

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  • The United Nations Millennium Declaration, signed by 189 heads of state in 2000, committed world leaders to achieving Millennium Development Goal (MDG) 5, improving maternal health (with targets of reducing the maternal mortality ratio—the number of maternal deaths per 100,000 live births—by three-quarters before 2015, and achieving universal access to reproductive health). Although more than half of countries are reducing maternal mortality at an accelerated pace, few are on track to achieve the goal by 2015.

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  • Although there is no doubt that maternal mortality is reducing, questions continue to be raised about the exact figure for MMR, for example the Bureau of Health Promotion retrospective study of maternal mortality during 1995-1996 using RAMOS approach (Reproductive Age Mortality Survey) revealed a much higher figure than national figures obtained from routine data. Estimates using the RAMOS approach suggest the maternal mortality ratio in 1991 was 44.3 per 100,000 live births and 43 per 100,000 live births in 1996.

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  • About half of all deaths from unsafe abortion are in Asia, with most of the remainder (44%) in Africa. 6 The unsafe abortion mortality ratio (the number of unsafe abortion-related deaths per 100 000 livebirths) varies across regions. For the developing world as a whole, this ratio was estimated to be 60 in the year 2000. However, the ratio is much higher in eastern, middle, and western Africa (90–140), and is lower in northern and southern Africa, western and southeastern Asia, and Latin America and the Caribbean (10–40).

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  • The publication of this textbook marks a great milestone in our joint efforts at achieving the Millennium Development Goal 5, which aims to reduce maternal mortality by three-quarters, a daunting task indeed for most developing countries. The African region, especially Eastern and Western Africa, has the highest ratio of women dying as a result of pregnancy or childbirth in the world, estimated at an average of 1000 per 100 000 live births.

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  • Indonesia’s maternal mortality is among the highest in the region, at an official ratio of 228/100,000. While this represents a decline from the ratio reported in previous years, it is far from the MDG target of 102/100,000 and an estimated 10,000 women die each year due to complications during labor and delivery. Most of these deaths are preventable. The leading causes of maternal mortality in Indonesia are hemorrhage (28%), eclampsia (24%), and sepsis (11%).

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  • Professional care at birth can help reduce maternal mor tality. The proportion of women who deliver with the assistance of a skilled health-care provider - doctor , nurse, midwife - is highly correlated with materna mortality ratios. Trends in this indicator during the 1990s suggest that significant progress has been made in developing countries, with an overall increase from 41% to 57% between 1990 and 2003. However , there are important differences across regions, as shown in Figure 6.

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