Figure A.1.2.

Maternal deaths, by WHO region, 2015

MATERNAL MORTALITY
SDG Target 3.1
By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births

AFR

(195 000)

Indicator 3.1.1: Maternal mortality ratio

AMR
(7900)

SITUATION

ACHIEVING THE 2030 TARGET

In 2015, the maternal mortality ratio (MMR)

defined as the number of maternal deaths per
100000 live births was estimated at 216
globally.1 This translates into approximately
830 women dying every single day due to the
complications of pregnancy and childbirth.
Almost all of these deaths occurred in lowresource settings, and most could have been
prevented. The WHO African Region bore the
highest burden with almost two thirds of global
maternal deaths occurring in the region (Fig.
A.1.2). The probability of a 15 year-old girl in
the region eventually dying from a maternal
cause was as high as 1 in 37 compared to 1
in 3400 in the WHO European Region.

During the course of the MDG era the global

MMR declined by 44% equating to an average
annual reduction of 2.3% between 1990 and
2015. Accelerated progress is now needed
as achieving the SDG Target 3.1 will require a
global annual rate of reduction of at least 7.3%.
Countries with an MMR of less than 432 deaths
per 100 000 live births in 2015 will need to
achieve an annual continuous rate of reduction
of 7.5%. For the 30 countries with MMRs greater
than 432 deaths per 100 000 live births in 2015,
even higher annual continuous rates of reduction
are needed to reduce the MMR to less than 140
deaths per 100 000 live births in 2030.3

The primary causes of maternal deaths are

haemorrhage (mostly bleeding after childbirth),
hypertension during pregnancy (pre-eclampsia
and eclampsia), sepsis or infections, and indirect
causes mostly due to interaction between preexisting medical conditions and pregnancy
(Fig. A.1.1).2
Figure A.1.1.
Global estimates for causes of maternal mortality
20032009
Pre-existing medical conditions
exacerbated by pregnancy
(such as diabetes, malaria,
HIV, obesity)
28%
Severe
bleeding
27%

Blood
clots
3%
Abortion
complications
8%
Obstructed
labour and
other direct
causes
9%

Infections
(mostly after
childbirth)
11%

Pregnanyinduced
high blood
pressure
14%

Most maternal deaths are preventable as the

health-care solutions for preventing or managing
the complications of pregnancy and childbirth
are well known. All women need access to goodquality antenatal, childbirth and postpartum care.
It is also crucially important to ensure access
to contraception in order to prevent unintended
pregnancies. Factors that prevent women from
receiving adequate health care during pregnancy
and childbirth include limited availability and poor
quality of health services, a lack of information
on available services, certain cultural beliefs
and attitudes, and poverty.

44

WORLD HEALTH STATISTICS: 2016

The SDG target on maternal mortality forms an

integral part of The Global Strategy for Womens,
Childrens and Adolescents Health, 20162030.4
The required acceleration in reducing maternal
mortality will not be possible without clinical and
non-clinical interventions, as well as political
and policy action. Although each country will be
different, the Strategies toward ending preventable
maternal mortality (EPMM) 5 initiative suggests
adaptive and highly effective interventions to
improve womens health before, during and after
pregnancy. Key EPMM strategic objectives are:
to address inequities in access to and quality
of sexual, reproductive, maternal and newborn
health information and services;
to ensure UHC for comprehensive sexual,
reproductive, maternal and newborn health
care;
to address all causes of maternal mortality,
reproductive and maternal morbidities, and
related disabilities;
to strengthen health systems to respond to
the needs and priorities of women and girls;
and
to ensure accountability to improve quality
of care and equity.

from complete civil registration systems, such

as those in developed countries, may not be
accurate, for example due to the misclassification
of maternal deaths.

SEAR

(61 000)

EUR

(1800)

Furthermore, although the 2015 MMR estimates

made by the United Nations Maternal Mortality
Estimation Inter-Agency Group were based on
data available for 171 countries, no data had been
provided since 2010 from 55 of these countries,
or since 2005 in the case of nine others.3

EMR

(28 000)

WPR
(9800)

REFERENCES
Unless otherwise noted, all statistics in the text, table and figures are
taken from: WHO, UNICEF, UNFPA, World Bank Group and the United
Nations Population Division. Trends in maternal mortality: 1990 to 2015.
Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United
Nations Population Division. Geneva: World Health Organization; 2015
(http://www.who.int/reproductivehealth/publications/monitoring/
maternal-mortality-2015/en/, accessed 25 March 2016).

Table A.1.1.
Maternal mortality ratio (per 100 000 live births), 2015a

Table A.1.1. Maternal mortality ratio (per 100000 live births), 2015
AFR
Cabo Verde

Say L, Chou D, Gemmill A, Tunalp , Moller AB, Daniels JD et al. Global

causes of maternal death: a WHO systematic analysis. Lancet Glob Health
2014;2(6):e323e333 (http://www.thelancet.com/journals/langlo/
article/PIIS2214-109X(14)70227-X/fulltext, accessed 25 February 2016).

Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A et al. Global,

regional, and national levels and trends in maternal mortality between
1990 and 2015, with scenario-based projections to 2030: a systematic
analysis by the UN Maternal Mortality Estimation Inter-Agency Group.
Lancet. 2016;387(10017):46274 (Online version published 12
November 2015: http://www.thelancet.com/pb/assets/raw/Lancet/
pdfs/S0140673615008387.pdf, accessed 25 March 2016).

The Global Strategy for Womens, Childrens and Adolescents Health,

20162030. Every Women Every Child; 2015 (http://globalstrategy.
everywomaneverychild.org/pdf/EWEC_globalstrategyreport_200915_
FINAL_WEB.pdf, accessed 11 April 2016).
Strategies toward ending preventable maternal mortality (EPMM).
Geneva: World Health Organization; 2015 (http://apps.who.int/iris/
bitstream/10665/153544/1/9789241508483_eng.pdf?ua=1, accessed
11 April 2016).

South Africa
Algeria

138
140
156

Costa Rica 25
Barbados 27

224
265

Grenada

27

Belize

28

Senegal
Ghana

315
319
335

Brazil 44

Benin
Congo
Zimbabwe

Saint Vincent and the Grenadines 45

Saint Lucia 48

342
343
353
353
368
371
389
398
405
442
443

Angola
Lesotho

477
487

Mozambique
Eritrea

489
501
510

Kenya
Guinea-Bissau
Niger

549
553

Argentina

52

El Salvador

54

Trinidad and Tobago

Colombia

63

Ecuador

64

Peru

68

Bahamas

80

Guatemala

88

Jamaica
Dominican Republic

89

Panama

94

Venezuela (Bolivarian Republic of)

95

64

92

Honduras

129

Paraguay

132

Nicaragua
Suriname

150
155

Bolivia (Plurinational State of)

206
229

Mali
Cameroon

587
596

Guyana

Mauritania
Malawi

602
634
645

SEAR
Thailand

20

679
693

Sri Lanka
Maldives

30

706
712

DemocraticPeoples
People's
Republic
of ..
Democratic
Republic
of Korea

82

Indonesia

126

725
789
814

Bhutan

148

India

174

Bangladesh
Myanmar

176

Timor-Leste

215

Nepal

258

Cte d'Ivoire
Guinea
Democratic Republic of the Congo
Gambia
Burundi
Liberia
South Sudan
Nigeria
Chad
Central African Republic
Sierra Leone
a

Uruguay 15
Chile 22

Mexico 38
Cuba 39

Swaziland
United Republic of Tanzania

DATA GAPS

United States of America 14

290
291

Togo
Burkina Faso

Maternal mortality is a health indicator that

shows very wide variations between rich and
poor, and between urban and rural areas both
between countries and within them. Poor women
in remote areas are the least likely to receive
adequate health care.

EUR
7

Rwanda
Gabon

Uganda
Ethiopia
Madagascar

EQUITY

Maternal mortality is a relatively rare event and

therefore difficult to measure. Civil registration
systems in most developing countries where
most maternal deaths occur are weak and
cannot therefore provide an accurate assessment
of maternal mortality. Even estimates derived

53
129

Comoros
Equatorial Guinea

Canada

Mauritius
Botswana

Sao Tome and Principe

Zambia
Namibia

AMR
42

359

Haiti

856
882
1360

68

178

Finland
Greece
Iceland
Poland
Austria
Belarus
Czech Republic
Italy
Sweden
Israel
Norway
Spain
Switzerland
Denmark
Germany
Slovakia
Belgium
Cyprus
Montenegro
Netherlands
Croatia
France
Ireland
The Former
Yugoslav
RepublicRepublic
of Macedonia
The former
Yugoslav
of ..
Estonia
Malta
Slovenia
United Kingdom
Lithuania
Luxembourg
Portugal
Bosnia and Herzegovina
Bulgaria
Kazakhstan
Turkey
Hungary
Serbia
Latvia
Republic of Moldova
Ukraine
Armenia
Azerbaijan
Russian Federation
Albania
Romania
Tajikistan
Georgia
Uzbekistan
Turkmenistan
Kyrgyzstan

EMR
3
3
3
3

Kuwait 4
United Arab Emirates

Libya

Saudi Arabia

12

Qatar

13

Bahrain

15

Lebanon

15

Oman

17

Iran (Islamic Republic of)

25

Egypt

33

Iraq

50

Jordan

58

Tunisia

62

Syrian Arab Republic

68

Morocco

121

Pakistan

178

5
5
5

7
7
8

229

Djibouti

311

Sudan
Yemen

385

Afghanistan

396

Somalia

9
9

732

WPR

Japan

Australia

Singapore

10

New Zealand

11

11

Republic of Korea

11

11

Brunei Darussalam

23

12

China

27

16

Fiji

30

17

Malaysia

40

Mongolia

44

Samoa

51

24

Viet Nam

54

25

Vanuatu

78

25

Kiribati

90

25

Micronesia (Federated States of)

100

29

Philippines

114

Solomon Islands

114

Tonga

124

36

Cambodia

161

42

Lao People's Democratic Republic

197

76

Papua New Guinea

215

10
10
10

17
18
23

31
32
36

WHO Member States with a population of less than 100 000 in 2015 were not included in the analysis.

MONITORING HEALTH FOR THE SDGs

45