WHO claims maternal mortality has been underestimated

BMJ 1996; 312 doi: (Published 17 February 1996) Cite this as: BMJ 1996;312:398
  1. Claudia Court

    Global maternal mortality has been underestimated in the past by as much as a third, say new figures produced jointly by the World Health Organisation and Unicef. There are nearly 80000 more pregnancy related deaths a year than previously reported. Each year the world has about 585000 maternal deaths, 99% of them in developing countries.

    The WHO says that 55% of maternal deaths occur in Asia, which accounts for 61% of the world's births. Africa, which has 20% of the world's births, accounts for 40% of all maternal deaths. Developed countries, with 11% of all births, have less than 1% of total maternal deaths.

    The estimates have been produced using statistical models developed specifically to cope with problems of underreporting. These problems, says the WHO, are common in developing countries with inadequate data but occur even in developed countries. For example, a pregnant woman may develop complications and be moved from the obstetric department to another specialist department where she then dies; the original cause of her complications is often not noted on the death certificate.

    Carla Abou-Zahr of the WHO's maternal health and safe motherhood programme, who worked on the study, said: “These estimates represent a substantial improvement on past figures and should be used as a stimulus to action.” Such action, she said, “must include greatly expanded access to quality care for all women during pregnancy and childbirth.”

    The figures show that in five regions—North Africa, Southern Africa, Eastern Asia, Central America, and South America—the estimates of maternal mortality are marginally lower than those available from earlier studies. Elsewhere, the risk of death that is related to pregnancy is higher.

    The WHO says: “The situation is particularly disquieting in eastern, middle and western Africa where the earlier estimates seem to have underestimated maternal mortality by nearly one third.”—CLAUDIA COURT, BMJ

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