Global Maternal Deaths Decline, Progress Slows in Recent Years

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

The Global Burden of Disease (GBD) 2023 research, published in The Lancet Obstetrics, Gynaecology, & Women’s Health, estimates that 240,000 women died from maternal causes in 2023, representing 5.5 per cent of all deaths among women aged 10–54 worldwide. 

Maternal deaths remain 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, led by researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and global collaborators, provides the most up-to-date assessment of maternal mortality trends across 204 countries and territories, including subnational estimates for 20 countries. It incorporates more than 1,000 new data sources and updated modelling approaches, as well as insights on causes of maternal death, progress toward global targets, and trends during and after the COVID-19 pandemic. 

While the global maternal mortality ratio declined by more than one-third—from 321 deaths per 100,000 live births in 1990 to 191 in 2023—it remains far above the Sustainable Development Goal (SDG) target. Progress was faster between 2000 and 2015, with annual declines of nearly three per cent, but has since slowed to about 0.5 per cent per year, with some countries recording increases. 

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

Dr. Maegan Ashworth Dirac, senior author and Assistant Professor of Health Metrics Sciences and Family Medicine, said although significant gains were made after 2000, progress has slowed since 2015 and, in some areas, reversed. She called for strengthened access to quality care before, during, and after pregnancy, especially in high-burden countries. 

The study noted that leading causes of maternal deaths remain largely preventable, with maternal haemorrhage and hypertensive disorders of pregnancy accounting for the largest share globally. It emphasized that improved access to antenatal care, safe delivery services, emergency obstetric care, and post-partum follow-up could significantly reduce mortality. 

However, data gaps persist in high-burden regions, limiting timely responses. Expanding high-quality vital registration systems, maternal death surveillance, and local data systems is critical for effective policymaking and investment. 

“Maternal mortality is both a health system challenge and a reflection of broader inequities affecting women’s health,” said Ira Martopullo, co-lead author and PhD candidate in Global Health Metrics at the University of Washington and IHME. He noted that while some countries have reduced maternal 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 delivery despite limited resources. 

The study also found that COVID-19 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 during the pandemic peak, health system disruptions and increased risks during pregnancy caused setbacks in several countries. 

In most locations with data for 2022 and 2023, maternal mortality has begun returning to pre-pandemic trends, demonstrating both resilience and vulnerability across health systems. 

Despite these improvements, maternal mortality levels remain 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 and sustained investment to accelerate progress, strengthen health systems, and improve monitoring and response mechanisms. 

Source: GNA