Modest global achievements in maternal survival: more focus on sub-Saharan Africa is needed

摘要

16 years ago, the target of a 75% reduction in the global maternal mortality ratio between 1990 and 2015 was specified as an indicatorfor Millennium Development Goal (MDG) number 5 to improve maternal health. As well as marking the end of the MDG era, 2015 also saw a new set of development targets proposed in the Sustainable Development Goals (SDGs), which are to be achieved over the next 15 years. Coinciding with the transition from MDGs to SDGs, analysis by the UN Maternal Mortality Estimation Inter-Agency Group, published in The Lancet, shows the extent to which the indicator for MDG 5 was met and what is needed to achieve the 2030 SDG target of reducing the global maternal mortality ratio to less than 70 per 100 000 livebirths, with no country exceeding twice that level. This impressive study pooled data from 171 countries to derive estimates of the maternal mortality ratio at national, regional, and global levels since 1990. The investigators also estimated the annual rate of reduction in the maternal mortality ratio over the same period and, assuming similar rates of change over the next 15 years as those seen from 2000 to 2010, contrasted model predictions of the maternal mortality ratio in 2030 with those needed if the SDG target is to be met. The authors report an estimated global maternal mortality ratio of 216 per 100 000 livebirths (80% uncertainty interval 207-249) in 2015- This estimate is a 44% decrease from 1990, which is encouraging, and a sign that substantial progress is possible. However, despite a marked reduction for many countries between 1990 and 2015, the maternal mortality ratio is still alarmingly high in many places, notably in sub-Saharan Africa, where many countries still have more than 500 maternal deaths per 100000 livebirths.