April 11, 2010
Maternal deaths fall worldwide from a half-million annually to less than 350,000
The number of women
dying from pregnancy-related causes has dropped by more than 35 percent in the past 30
years – from more than a half-million deaths annually in 1980 to about 343,000
in 2008, according to a new study by the Institute for Health Metrics and
Evaluation (IHME) at the University of Washington and collaborators at the
University of Queensland.
IHME’s
research shows that deaths have been declining at an annual rate of about 1.4 percent since 1990. Contrary to previous reports that have shown very little change in
the maternal mortality ratio (MMR), the global MMR – the number of women dying
for every 100,000 live births – declined from 422 in 1980 to 320 in 1990. It
reached 251 in 2008 and is on pace for further declines.
Developing
countries, in particular, have made substantial progress toward the Millennium
Development Goal set in 2000 of reducing the MMR. Although only 23 countries
are on track to achieve the target of lowering the MMR by 75 percent between 1990 and
2015, countries such as Egypt, China, Ecuador, and Bolivia have been achieving
accelerated progress.
“These
findings are very encouraging and quite surprising,” said Dr. Christopher
Murray, Institute Director and one of the report’s co-authors. “There are still
too many mothers dying worldwide, but now we have a greater reason for optimism
than has generally been perceived.”
The study,
“Maternal mortality for 181 countries, 1980-2008: a systematic analysis of
progress towards Millennium Development Goal 5,” appears April 12 in the online-first edition of The Lancet. Beginning in 2007,
researchers analyzed vital registration data, censuses, surveys, and verbal
autopsy studies and created new methodological tools to generate the most
accurate estimates to date of maternal mortality for nearly every country.
Researchers
found that progress in reducing maternal mortality has been slowed by the
ongoing HIV epidemic. Nearly one out of every five maternal deaths – a total of
61,400 in 2008 – can be linked to HIV, and many of the countries with large
populations affected by HIV have had the most difficulty reducing their
maternal mortality ratio.
Nearly 80 percent of
all maternal deaths are concentrated in 21 countries, and six countries account
for more than half of all maternal deaths.
Eight
low-income countries have seen annual increases in the MMR over the period 1990
to 2008, including Afghanistan and Zimbabwe, as have several high-income
countries, such as the United States, Canada, and Norway. At least part of the
increase in high-income countries appears to be due to changes in the way
maternal deaths are reported. Mothers in the United States now die at a higher rate than
in most other high-income countries, four times the rate of Italy and three
times the rate of Australia.
“As we gather more data, we will have a
better sense of how much of the rise in maternal deaths can be traced to better
reporting and how much may be due to other factors,” said Margaret Hogan, an
IHME researcher and the paper’s lead author.
Maternal
mortality is better documented than deaths from HIV, tuberculosis, and other
causes, the researchers found. They intend to share the new methods they have
created for estimating maternal mortality to help governments, development
agencies, and aid organizations better understand trends in the MMR.
“If we can
find out why a country such as Egypt has had such enormous success in driving
down the number of women dying from pregnancy-related causes, we might be able
to export that success to countries that have been
lagging behind,” said Murray.
IHME will
further explore maternal mortality in IHME’s upcoming report, “Building Momentum: Global progress toward
reducing maternal and child mortality,” to be published later this
spring.
The Institute
for Health Metrics and Evaluation (IHME) is
an independent global research center at the University of Washington providing
sound measurement of population health and the factors that determine health,
as well as rigorous evaluation of health system performance. IHME’s ultimate
goal is to improve population health by providing the best evidence possible to
guide health policy – and by making that evidence easily accessible to decision-makers. For more information, please visit:
http://www.healthmetricsandevaluation.org
