Global Maternal Mortality Remains High Despite Two Decades Of Progress

ISLAMABAD (GNP): More than 700 women died every day in 2023 from preventable causes related to pregnancy and childbirth, according to the latest World Health Organization data, amounting to roughly 260,000 maternal deaths globally for the year, or a death occurring almost every two minutes. The figures underscore that despite sustained global attention, maternal mortality remains a major and largely preventable public health burden.

The global picture nonetheless reflects real progress over time. Between 2000 and 2023, the worldwide maternal mortality ratio, the number of maternal deaths per 100,000 live births, fell by approximately 40%. That decline, however, has been sharply uneven across regions, with just over 90% of all maternal deaths in 2023 concentrated in low- and lower-middle-income countries.

Sub-Saharan Africa and southern Asia together accounted for around 87% of the global total in 2023, with sub-Saharan Africa alone responsible for roughly 70% of maternal deaths worldwide. Even so, both regions have made measurable gains: sub-Saharan Africa’s mortality ratio fell by 40% between 2000 and 2023, while southern Asia achieved a 71% reduction over the same period, among the sharpest declines recorded anywhere in the world. Eastern Europe posted the single largest regional improvement, with a 75% drop in its mortality ratio.

These disparities are closely linked to conflict, institutional fragility, and unequal access to skilled care. Countries classified as being in conflict or fragile institutional settings represented only about a quarter of the world’s live births in 2023, yet accounted for 61% of global maternal deaths, with mortality ratios in conflict-affected areas running roughly five times higher than in stable, non-fragile settings.

Access to skilled birth attendance follows a similar divide: close to 99% of births in high- and upper-middle-income countries are attended by a trained midwife, doctor, or nurse, compared with just 73% in low-income countries and 84% in lower-middle-income countries.

The immediate clinical causes of most maternal deaths are well documented and, in the large majority of cases, preventable. Severe bleeding after childbirth, infections, hypertensive disorders such as pre-eclampsia and eclampsia, complications during delivery, and unsafe abortion together account for around 75% of maternal deaths globally.

WHO guidance points to established interventions, including oxytocic medication to control postpartum bleeding and magnesium sulfate to manage pre-eclampsia before it develops into more severe complications, as measures capable of significantly reducing these risks when delivered through adequately staffed health systems.

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Academic research examining the structural barriers behind these outcomes has pointed to a recurring pattern known as the “three delays” framework, first developed in the 1990s: delays in a woman or her family recognizing an emergency and deciding to seek care, delays in physically reaching a health facility, and delays in receiving adequate treatment once there.

Studies applying this framework in countries including Tanzania, Malawi, and Zimbabwe have identified household decision-making dynamics, transportation shortages, and under-resourced rural facilities as recurring contributors to preventable deaths, with some regions piloting targeted responses such as emergency transport programs for women in remote areas.

Global targets for reducing maternal mortality remain far from being met on current trends. The United Nations’ Sustainable Development Goals call for lowering the global maternal mortality ratio below 70 per 100,000 live births by 2030, but the ratio stood at 197 per 100,000 in 2023, meaning the target would now require an annual rate of reduction rarely sustained at a national level.

WHO has said it continues working with member states to expand universal coverage for reproductive and maternal health care, strengthen data collection systems, and address inequalities in access to quality care as the 2030 deadline approaches.