Vector Issue 12 - 2011

Progress to date:
MDG5 is the worst performing MDG 2 . Since 1980,
the world MMR has declined 1.3 percent (CI 1.0-1.5)
annually to 251 deaths/100,000 live births in 2008 3 .
Similarly, there has been a 1.5 percent annual decline
in the gross number of deaths, from 526,300 to 342
900 (CI 302 100-394 300) 3 . These figures are smaller
than the 3 percent annual decline necessary to meet
the MDG5 target between 1990 and 2015.
Over half the maternal deaths in 2008 occurred
in just 6 countries: India, Nigeria, Pakistan,
Afghanistan, Ethiopia and the Democratic Republic
of the Congo. Afghanistan has the highest MMR, at
1575/100,000 3 ]. For comparison, Australia’s MMR is
5/100,000 3 .
‘‘
MDG 5 is the
worst performing
millenium
Access to modern contraception is an effective
primary prevention strategy against unsafe abortion,
which causes 8 maternal deaths an hour [9 , and
maternal mortality generally 10 . Modern contraceptive
use has increased in all regions 11] , however remains
so low that 76 million unintended pregnancies occur
each year 12 : 41 percent of pregnancies globally are
unwanted and 22 percent result in induced abortion 13 .
Access to safe, legal abortion has been shown to
reduce abortion mortality 10 .
‘‘
development goal
World Global Monitoring Report 2010
Maternal mortality progress from 1980-2008 3
Reasons for high maternal mortality:
The most common immediate causes of maternal
death are post-partum haemorrhage, sepsis,
hypertensive disorders, unsafe abortion, and
obstructed labour 4 . The majority of deaths occur
around labour, delivery, and 5-48 hours post-partum 5 .
Broader socio-economic factors contributing
to maternal deaths include poverty 6 , which is
improving 2 , disempowerment of women, and HIV 3, 5 .
Solutions:
Ensuring access to skilled attendance at delivery, and
emergency obstetric care for birth complications,
can potentially prevent 250,000 maternal deaths per
year 7 . A strategy where women deliver their children
in a health facility attended by midwives, with other
attendants such as doctors available if complications
arise, is the ‘best bet’ for reducing maternal
mortality 8 .
In India, a scheme where women are given cash
incentives to deliver their babies at health facilities
has increased the number of in-facility births 14 . If
adopted globally, this scheme could reduce maternal
deaths due to poverty.
Women are gradually becoming more empowered.
Girls were attending primary school at the same
rate as boys in almost 2/3 of developing countries by
2005 2 ]. Educated women marry later, have greater
decision-making power in households, and have
fewer, healthier and better-nourished children 15 .
Furthermore, more women than before are able to
earn income through access to small business loans,
known as microfinance.
Maternal mortality progress from 1980-2008 3
vector FEB 2011
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