Maternal & Reproductive Health

We know that the strength of a community depends on the strength of its mothers, and the fate of a child is inextricably tied to the health of its mother.

Great progress has been made in reducing the number of women who die in childbirth. Global maternal mortality has been halved from an estimated 543,000 maternal deaths in 1990 to about 260,000 in 2013. But in order to meet Millennium Development Goal 5, we must more than quadruple the current rate of maternal mortality reduction so that fewer than 140,000 mothers die in 2015. This will require a rapid acceleration in access to prenatal care, institutional deliveries, skilled birth attendants, life-saving maternal health commodities and family planning services, including contraceptives to prevent unwanted pregnancies.

Target

At the current rate of progress, the projected 2015 maternal deaths will be 230,000 deaths/year. Our aim is to accelerate progress to meet MDG5 by:

  • Lowering maternal deaths from 260,000 per year to fewer than 140,000/year
  • Increasing access to contraception for 30 million women, in order to meet 25% of the current unmet need for family planning

Situation

Maternal mortality has decreased significantly over the last two decades. Between 1990 and 2000, deaths decreased 22% from 540,000/year to 420,000/year. Between 2000 and 2010 maternal deaths decreased an additional 31% to 290,000/year.

Hemorrhage and eclampsia alone account for more than half of the maternal deaths. The other major causes of maternal death include complications from unsafe abortions and sepsis. Together, these four causes of death account for approximately 70% of global maternal mortality. Focusing on these causes alone could save an additional 110,000 lives by 2015.

Lack of access to family planning results in 80 million unintended pregnancies annually, or 40% of all pregnancies worldwide. Meeting 25% of the unmet need for family planning could prevent more than 11 million unintended pregnancies and, in turn, avert the deaths of 25,000 mothers and 250,000 newborns.

Maternal deaths and gaps in family planning are largely concentrated in two regions: Sub-Saharan Africa and South Asia, which represent 57% and 29% of the global maternal mortality burden, respectively. Within these regions, just 10 countries account for approximately 170,000 maternal deaths annually, around 60% of the global burden.

Approach

In order to reach the MDG5 target, the Special Envoy’s Office will focus on mobilizing resources to prevent (through family planning) and treat (through access to commodities and skilled care) causes of maternal mortality. Our strategy leverages private sector competencies as well as government, NGO and UN networks.

We know that just a handful of commodities and interventions can address the main causes of maternal death and save thousands of lives. These include contraception and other family planning commodities to prevent unwanted births; demand creation and behavior change campaigns, including innovative cash transfer programs to drive ante-natal visits; optimal maternal nutrition; skilled birth attendance and institutional delivery; Oxytocin/Misoprostol to prevent and manage hemorrhage and treatment of post-abortion complications; clean delivery kits and inexpensive antibiotics to prevent and treat sepsis; and magnesium sulfate for the prevention and management of eclampsia.

The Special Envoy’s Office is initially focused on the countries that account for over 60% of the burden of maternal mortality: India, Nigeria, Democratic Republic of Congo, Pakistan, Tanzania, Ethiopia, Afghanistan, Indonesia, Sudan, Bangladesh and Uganda.

We’ve seen the impact that the delivery and use of a few affordable interventions can have and will look to accelerate progress through new and existing funding mechanisms like the Reproductive, Maternal, Newborn and Child Health (RMNCH) Trust Fund, UNFPA, USAID, the World Bank and the Global Fund, as well as the private sector and foundations such as the Bill and Melinda Gates Foundation, Johnson & Johnson and Merck for Mothers. We also expect to see increased levels of domestic funding from countries with significant maternal health challenges.