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5 - Peoples of the MekongIn Thailand, declines in the fertility rate, combined with government programmes to promote safemotherhood practices, have led to a dramatic drop in the MMR, from about 200 women per 100,000live births in 1990, to 44 in 1996. The principal causes of maternal deaths in Thailand are complicationsduring labour and delivery. 49 In Viet Nam, improvements in reproductive health services halved theMMR between 1990 and 2000, although the rate in the Central Highlands remains extremely high at418 deaths per 100,000 live births. 50Throughout the basin, MMR tends to be higher in rural areasand in areas with large ethnic minority populations. Significantprogress has been made to reduce the MMR in areas where itis very high. For example, in the Northern Region of Lao PDR,the MMR dropped by more than 100 percent between 1995and 2000 (from over 1,100 to 520 deaths per 100,000 live births). 51In Cambodia, the rate has dropped from an estimated 1990 rateof 900 deaths per 100,000 live births to a level under 500. 52Continued improvement in MMR will come as rural and ethnicwomen achieve higher education levels, have greater access tohealth services and as governments promote birth spacingprogrammes.Maternal morality rates inCambodia and Lao PDR are amongthe highest in AsiaThe Millennium Development Goals targets include areduction of 75 percent in MMR by 2015. In Viet Nam,the 2010 target is 70 deaths per 100,000 live births. 53In Cambodia, the Five-Year Action Plan anticipatesthat with the introduction of a Safe MotherhoodProgramme, the MMR can be reduced to 250 deathsper 100,000 live births by 2015. 54Malaria and HIV/AIDS. There is widespreadendemic tropical disease in the LMB, much of whichis related to contaminated water. Malaria is the leadingpublic health problem throughout the LMB, particularlyin Cambodia and Lao PDR. In some provinces ofnortheast Cambodia, the incidence rates range fromTable 8. Reproductive health, 1998-2000(most recent year)Maternal mortality(per 100,000 live births)Cambodia 473Lao PDR 530Thailand 44Viet Nam 100Sources: Ministry of Health, Thailand 1998;UNDP 2002; UNDP-Viet Nam 2001c;UNFPA 20012,000-3,000 people per 100,000 people. 55 Malaria-endemic areas of Viet Nam include the CentralHighlands and southern provinces, where morbidity and mortality rates are, respectively, 50 and 150Table 9. Incidence of malaria and HIV/AIDSMalaria incidence, 1997(per 100,000 people)HIV/AIDS prevalence,1999 (% 15-49 years)Cambodia 1,096 3.20Lao PDR 1,076 0.05Thailand 163 2.15Viet Nam 86 0.22Sources: UNAIDS 2000; UNDP 2002; UNDP-Cambodia 2001percent above nationalaverages. 56 The high incidencein remote areas of the LMB isrelated to unsafe water supplies,inadequate sanitation and thelack of sufficient, accessiblehealth services.53