Global Maternal Deaths Decline, but Progress Slows in Recent Years

A new study shows that while global maternal deaths have declined over the past three decades, progress has slowed in recent years and remains uneven across countries.

Findings from the Global Burden of Disease (GBD) 2023 research, published in The Lancet Obstetrics, Gynaecology & Women’s Health, estimate that approximately 240,000 women died from maternal causes in 2023. This represents 5.5 percent of all deaths among women aged 10–54 worldwide.

Maternal deaths continue to be concentrated in regions facing significant health system and data challenges, particularly sub-Saharan Africa, Oceania, South Asia, Southeast Asia, and parts of the Caribbean. Countries with the highest numbers of maternal deaths in 2023 included Nigeria, India, the Democratic Republic of the Congo, Ethiopia, and Pakistan.

The analysis, conducted by researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington alongside global collaborators, provides one of the most comprehensive and up-to-date assessments of maternal mortality trends. Covering 204 countries and territories, it incorporates more than 1,000 new data sources and updated modelling approaches, alongside insights into causes of maternal death, progress toward global targets, and the effects of the COVID-19 pandemic.

Globally, the maternal mortality ratio has declined by more than one-third, dropping from 321 deaths per 100,000 live births in 1990 to 191 in 2023. However, this remains well above the Sustainable Development Goal (SDG) target. Progress was strongest between 2000 and 2015, with annual declines of nearly three percent, but has since slowed significantly to about 0.5 percent per year, with some countries even experiencing increases.

In 2023, the highest maternal mortality ratios were recorded in sub-Saharan Africa, as well as parts of the Caribbean and Oceania. Countries particularly affected included Liberia (1,210 deaths per 100,000 live births), the Central African Republic (865), Haiti (819), Eritrea (768), Sierra Leone (762), Chad (728), the Democratic Republic of the Congo (713), Cameroon (661), Guinea (626), and Gabon (586).

Researchers note that although substantial gains were made after 2000, progress has slowed since 2015 and, in some cases, reversed. They stress the urgent need to strengthen access to quality care before, during, and after pregnancy, especially in high-burden countries.

The study highlights that most maternal deaths are preventable. The leading causes globally remain maternal haemorrhage and hypertensive disorders of pregnancy. Expanding access to antenatal care, safe delivery services, emergency obstetric care, and post-partum follow-up could significantly reduce mortality.

However, persistent data gaps in high-burden regions continue to limit timely and effective responses. Strengthening civil registration systems, maternal death surveillance, and local data infrastructure is critical for informed policymaking and targeted investment.

The findings also underscore that maternal mortality reflects broader inequalities in women’s health. While some countries have reduced deaths through economic growth and improved health systems, others—such as Ethiopia, Bangladesh, Nepal, and Cambodia—have achieved progress by expanding access to facility-based deliveries despite limited resources.

The COVID-19 pandemic contributed to temporary increases in maternal deaths during 2020 and 2021, particularly in regions with high infection rates, including parts of Latin America and the Caribbean, Central and Eastern Europe, Central Asia, and high-income North America. Although global maternal mortality remained relatively stable at the peak of the pandemic, disruptions in healthcare services and increased risks during pregnancy led to setbacks in several countries.

Encouragingly, data from 2022 and 2023 suggest that maternal mortality is beginning to return to pre-pandemic trends in many locations, reflecting both resilience and ongoing vulnerability within health systems.

Despite these improvements, maternal mortality remains far above global targets in many regions. With less than five years to achieve SDG target 3.1, the study calls for renewed global action, sustained investment, and strengthened health systems to accelerate progress and save lives.

Source: GNA