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Trends in Maternal Mortality Show Declines but Challenges Remain

Zolot, Joan PA

AJN, American Journal of Nursing: February 2016 - Volume 116 - Issue 2 - p 17
doi: 10.1097/01.NAJ.0000480484.21676.9b
In the News

Humanitarian crises, natural disasters, and war stymie improvements.

Joan Zolot, PA

The goal established by United Nations member states to reduce the worldwide maternal mortality ratio (MMR)—the number of maternal deaths per 100,000 live births—by 75% between 1990 and 2015 wasn't achieved, but significant progress has been made. The 2015 global MMR is estimated at 216 deaths per 100,000 live births, down from 385 in 1990, a 43.9% decline, although progress varies widely by region; developing regions still have disproportionately higher MMRs, according to a study in the Lancet.

The differences between developed and developing regions are stark: there are currently 12 maternal deaths per 100,000 live births in developed regions, compared with 546 in sub-Saharan Africa. Nine of the 10 countries with the lowest MMRs are in Europe, according to a new report from the World Health Organization; these 10 countries have three or four maternal deaths per 100,000 live births. Sierra Leone has the highest MMR of all, at 1,360. The United States’ MMR is 14, which is higher than in similarly developed countries and puts us in 45th place.

The greatest rate of decline over the 25-year period was in eastern Asia; the lowest was in the Caribbean. Greater travel distances to health care, poorer-quality health care or facilities, a poor transportation infrastructure, and inadequate cell phone technology all contribute to higher MMRs. Countries that were able to improve some of these issues over time had substantial declines in MMR.

Higher HIV and AIDS prevalence, too, is associated with maternal death, and increasing the availability of antiretroviral therapy internationally could improve MMRs. But in many regions, like those experiencing humanitarian crises, natural disasters, or war, improving maternal health remains difficult.—Joan Zolot, PA

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Alkema L, et al. Lancet Nov 13, 2015 [Epub ahead of print]; World Health Organization. Trends in Maternal Mortality: 1990 to 2015. Geneva; 2015 Nov.
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