Five Countries Account for One-Third of Global Maternal Deaths: Causes, Challenges & Solutions

Introduction

A recent study published in The Lancet has revealed a troubling global health reality—just five countries, including India, account for nearly 36% of global maternal deaths. This highlights slow progress toward the United Nations Sustainable Development Goals (SDGs), particularly the target of reducing maternal mortality by 2030.

Despite medical advancements, maternal deaths remain a major challenge due to a mix of clinical, systemic, and socio-economic factors.

What are Maternal Deaths?

Q1. What is maternal death?

Maternal death refers to the death of a woman during pregnancy, childbirth, or within 42 days of termination of pregnancy, due to complications related to or aggravated by pregnancy.

Major Causes of Maternal Deaths

Maternal deaths can be broadly classified into direct (medical) and indirect (systemic or health-related) causes.

1. Primary Clinical Causes

A. Haemorrhage (Severe Bleeding)

• Historically the leading cause of maternal deaths globally
• Declined from 36.1% (1990) to 21.7% (2023)

In India:

• Accounts for 33.7% of maternal deaths (2023)
• Still the single largest cause

Reason:

• Delay in emergency care
• Lack of blood transfusion facilities

B. Hypertensive Disorders

Includes:

• Pre-eclampsia
• Eclampsia

Trend:

• Increased globally from 16.6% to 20.1%
• In India: rose from 10% to 12.1%

These conditions are preventable if detected early, but weak prenatal care limits diagnosis.

2. Emerging Risks: The “Postnatal Gap”

Late Maternal Deaths

• Occur between 43 days and 1 year after childbirth
• Globally increased from 1.3% to 3.2%

This reveals a critical postnatal care gap, where:

• Medical attention sharply declines after delivery
• Women are often left without follow-up care

3. Indirect Causes and Comorbidities

The COVID-19 pandemic exposed vulnerabilities in health systems:

• Disrupted maternal healthcare services
• Increased mortality rates
• Reduced hospital access

Other indirect factors include:

• Anaemia
• Malnutrition
• Pre-existing diseases

Systemic and Structural Causes of Maternal Deaths

Beyond medical reasons, maternal mortality is deeply linked to health system failures and socio-economic conditions.

1. Weak Primary Healthcare Systems

• Lack of regular antenatal check-ups
• Late detection of complications
• Poor rural healthcare infrastructure

2. Emergency Care Gaps

In countries like India and Nigeria:

• Delays in reaching hospitals
• Lack of skilled birth attendants
• Inadequate emergency obstetric care

The “Three Delays Model” explains:

1. Delay in decision to seek care
2. Delay in reaching care
3. Delay in receiving care

3. Regional Disparities

Even within countries:

• Urban areas show improvement
• Rural and tribal regions remain high-risk hotspots

South Asia and Sub-Saharan Africa account for the majority of global maternal deaths.

4. Data Invisibility and Underreporting

• Many deaths occur at home
• Poor civil registration systems
• Lack of real-time data tracking

This leads to:

• Weak accountability
• Ineffective policy response

Why is This a Global Concern?

1. SDG Target at Risk

The UN aims to reduce global maternal mortality ratio (MMR) to below 70 per 100,000 live births by 2030.

Current trends suggest many countries may miss this target.

2. Public Health Indicator

Maternal mortality reflects:

• Healthcare quality
• Gender inequality
• Socio-economic development

3. Intergenerational Impact

• Affects newborn survival
• Impacts family health and income
• Reinforces poverty cycles

Solutions: How Can Maternal Deaths Be Reduced?

1. Strengthening Primary Healthcare

• Universal antenatal care
• Early screening for hypertension and anaemia

2. Improving Emergency Obstetric Care

• 24×7 healthcare facilities
• Skilled birth attendants
• Blood banks and referral systems

3. Bridging the Postnatal Care Gap

• Regular follow-ups after childbirth
• Monitoring up to 1 year postpartum

4. Leveraging Digital Health Systems

• Real-time maternal health tracking
• Use of mobile health platforms

5. Addressing Regional Inequality

• Target high-burden districts
• Strengthen rural health infrastructure

6. Data Strengthening and Accountability

• Improve civil registration systems
• Maternal death audits

Conclusion

The finding that five countries account for over one-third of global maternal deaths is a wake-up call for global health systems. While progress has been made, persistent gaps in healthcare access, quality, and equity continue to cost lives.

For countries like India, the challenge is not just expanding healthcare—but ensuring accessible, timely, and continuous care for every woman.

Achieving SDG targets will require:

• Policy commitment
• Health system strengthening
• Community-level interventions

Maternal health is not just a medical issue—it is a measure of a nation’s development and social justice.

FAQs -Five Countries Account for One-Third of Global Maternal Deaths

Q1. What is the leading cause of maternal death?

Haemorrhage (severe bleeding) remains the leading cause globally and in India.

Q2. What are late maternal deaths?

Deaths occurring between 43 days and one year after childbirth.

Q3. Why are maternal deaths high in developing countries?

Due to weak healthcare systems, poor access to emergency care, and socio-economic factors.

Q4. What is the SDG target for maternal mortality?

Below 70 deaths per 100,000 live births by 2030.

Q5. How can maternal mortality be reduced?

Through better healthcare access, emergency care, postnatal follow-up, and strong data systems.

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The Source’s Authority and Ownership of the Article is Claimed By THE STUDY IAS BY MANIKANT SINGH