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Feature Medicine in Developing Countries

How can child and maternal mortality be cut?

BMJ 2010; 340 doi: (Published 26 January 2010) Cite this as: BMJ 2010;340:c431
  1. Tatum Anderson, freelance journalist
  1. 1London
  1. tatum.anderson{at}

    With only five years to go, the millennium development goals to reduce maternal and child mortality remain a long way off target. Tatum Anderson looks at the problems

    A decade ago world leaders identified deaths of women in childbirth and of children under the age of 5 years as two of eight key problems that must be tackled in order to lift millions out of extreme poverty by 2015.

    Ten years on and international agencies are less than optimistic that the goal of cutting deaths among under 5s by two thirds by 2015 will be met without a great deal more effort. Most of the 8.8 million children who died before their 5th birthdays in 2008 were in developing countries. Over 43% were newborn babies, who died in the first few days of life, and undernutrition contributed to a third of deaths. But although progress has been made in tackling many of the causes, including pneumonia, diarrhoea and malaria, it is not enough. Of 67 countries with high mortality rates (≥40/1000), a staggering 47 are off track to meet the target.1

    Yet more pessimism is reserved for the millennium development goal for maternal mortality. The aim is to reduce the maternal mortality ratio by three quarters and offer universal access to reproductive health. It is considered to be the goal that is furthest off track.

    Up to date statistics on maternal death are more difficult to come by. But maternal mortality ratios are “high or very high” in all but 12 of the 68 countries working towards this millennium development goal, according to the Countdown to 2015 Initiative, a collective of research institutions and aid agencies that includes the London School of Hygiene and Tropical Medicine and the Norwegian Agency for Development Cooperation (Norad).2. In Sierra Leone …

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