|Ensure that women have ready and affordable access to skilled attendance at delivery||Target: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio|
Maternal Mortality Reports
WHO, UNICEF, UNFPA and The World Bank: Trends in Maternal Mortality: 1990 to 2008
The new UN Inter-Agency Maternal Mortality estimates 1990-2008 have been released
The new UN Inter-agency Maternal mortality estimates, which for the first time include both country and regional trends from 1990 to 2008, have been released. These estimates will replace the previous 2005 inter-agency estimates and will be used for official UN MDG5 monitoring and reporting.
In the new report, the inter-agency group estimates that there were 358 000 maternal deaths worldwide in 2008. This represents a 34% decline from the 1990 level. Despite this encouraging decline, developing countries continued to account for 99% (355 000) of the deaths. Sub-Saharan Africa and South Asia accounted for 87% (313 000) of global maternal deaths.
During the period 1990–2008, 85% of the 172 countries included in this analysis experienced a decline in MMR. Of these, 90 countries showed a decline of 40% or more.
The fifth MDG aims to improve maternal health with a target of reducing MMR by three quarters between 1990 and 2015 – that is, it seeks to achieve a 5.5% annual decline in MMR. Globally the annual percentage decline in MMR between 1990 and 2008 was only 2.3%. Among countries with an MMR =100 in 1990, it is evident that 30 countries have made insufficient or no progress, including 23 from sub-Saharan Africa.
The Maternal Mortality Estimation Inter-agency Group
The 2008 UN inter-agency estimates were produced by the Maternal Mortality Estimation Inter-agency Group (MMEIG) which is composed of WHO, UNICEF, UNFPA and The World Bank, as well as an independent Technical Advisory Group made up of outside technical experts. This inter-agency group began working together in the mid-1990s with the goal of providing a more accurate assessment of the global maternal mortality burden, as well as comparable estimates across countries. The MMEIG has produced peer reviewed sets of estimates that have been critical for MDG5 monitoring and reporting.
Reasons to produce UN Inter-agency maternal mortality estimates
Maternal mortality is difficult to measure and existing data suffer from significant levels of misclassification and underreporting of maternal deaths. Calculating the maternal mortality ratio requires more information than just knowing that a death occurred; to accurately categorize a death as maternal information is needed regarding cause of death, pregnancy status and timing of death in relation to the pregnancy. It is difficult to obtain accurate data on all three of these elements, particularly in settings where substantial proportions of births take place at home. This information may be missing or misclassified not only in developing countries but also in industrialized countries with fully functioning vital registration systems.