Efforts to cut maternal deaths falter in developing countries, UN study finds

Death associated with pregnancy and childbirth - a peril that has been virtually eliminated in developed countries - still affects over 500,000 women in the developed world, according to a new study released today by the United Nations World Health Organization (WHO).

The WHO study, published in the latest issue of WHO's Bulletin, finds that many developing countries will fail to reach UN targets for reductions in maternal mortality. In sub-Saharan Africa, maternal deaths may be stagnating at high levels or may even be increasing in some places.

While estimates suggest that maternal mortality claims the lives of some 515,000 women per year, the study points out that accurate data is lacking for most developing countries, and that in some of them up to 50 per cent of such deaths are never recorded. "All the evidence indicates significant under-reporting and misclassification of maternal deaths," the authors note.

In the absence of reliable direct data on maternal mortality, progress is measured by the proportion of births attended by a skilled health worker. The study finds that in the developing world, only Latin American and Caribbean countries will attain the UN goal of ensuring that 80 per cent of all childbirths are assisted by a skilled health care worker by the year 2005. Countries in the Middle East and North Africa will not attain the goal until around 2010, and Asian countries as a whole will fall short of it even by 2015.

In sub-Saharan Africa, where maternal mortality is highest, only about 40 per cent of women are likely to have an assisted delivery - a situation which has not improved over the past decade. "The figures for many countries in sub-Saharan Africa paint a sombre picture of slow change, stagnation and even reversal," the authors say.

On the up side, the study shows significant improvements in the proportion of childbirths attended by skilled attendants in a number of countries, including Bolivia, Egypt, Indonesia, Morocco and Togo.

The study was conducted by Carla AbouZahr, an expert on family and community health at WHO, and Tessa Wardlaw, senior project officer for statistics and monitoring at the UN Children's Fund (UNICEF).