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Global Maternal Deaths Decline Over Three Decades, Progress Slows Since 2015

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Global Maternal Deaths Decline, But Progress Stalls and Disparities Persist

Global maternal deaths have decreased over the past three decades, though progress has slowed in recent years and remains uneven across countries.

New Global Burden of Disease (GBD) 2023 research, published in The Lancet Obstetrics, Gynaecology, & Women's Health, reveals a complex picture of maternal mortality worldwide. While overall deaths have declined, the pace of progress has decelerated significantly, leaving many regions behind.

Current Landscape: 240,000 Deaths in 2023

In 2023, an estimated 240,000 women died from maternal causes, accounting for 5.5% of all deaths among women aged 10-54 worldwide. These tragic losses are heavily concentrated in regions grappling with profound health system and data challenges.

Specifically, sub-Saharan Africa, Oceania, South Asia, Southeast Asia, and parts of the Caribbean bear the highest burden. Globally, Nigeria, India, the Democratic Republic of the Congo, Ethiopia, and Pakistan recorded the highest numbers of maternal deaths in 2023.

About the Research

This comprehensive analysis was led by researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, in collaboration with international partners. It provides an updated global assessment of maternal mortality trends across 204 countries and territories through 2023. The study also includes subnational estimates for 20 countries, integrating over 1,000 new data sources and employing updated modeling approaches for enhanced accuracy.

Maternal Mortality Trends: A Slowing Decline

The global maternal mortality ratio has seen a substantial decline of more than one-third, from 321 deaths per 100,000 live births in 1990 to 191 in 2023. This progress was particularly rapid between 2000 and 2015, with annual declines averaging nearly 3%.

However, a concerning trend has emerged: since 2015, the rate of decline has slowed considerably, averaging only about 0.5% per year. In fact, some countries have experienced outright increases in maternal mortality. The current ratio regrettably remains above the Sustainable Development Goal (SDG) target.

Regions of Highest Burden

In 2023, the highest maternal mortality ratios were predominantly observed across the four regions of sub-Saharan Africa, as well as parts of the Caribbean and Oceania. Countries facing particularly elevated rates included:

  • Liberia
  • Central African Republic
  • Haiti
  • Eritrea
  • Sierra Leone

Preventable Causes and Solutions

The leading causes of maternal deaths are known and largely preventable. Maternal hemorrhage and hypertensive disorders of pregnancy are responsible for the largest share of deaths globally.

Significant reductions in mortality are achievable through improvements in access to essential care, including:

  • Antenatal care
  • Safe delivery services
  • Emergency obstetric care
  • Postpartum follow-up

These interventions are especially crucial in countries with the highest burdens.

The Critical Role of Data

Many high-burden regions continue to be data-sparse, creating significant obstacles in tracking progress and effectively responding to challenges. Expanding high-quality vital registration, maternal death surveillance, and local data systems is considered critical for guiding effective policy and investment. Better data enables targeted interventions and improved accountability.

COVID-19's Temporary Impact

COVID-19 infection led to temporary increases in maternal mortality during 2020 and 2021, prior to widespread vaccination. These increases were observed in several regions, including parts of Latin America and the Caribbean, Central and Eastern Europe, Central Asia, and high-income North America, temporarily reversing progress in some countries. By 2022 and 2023, maternal mortality in most places with available data returned towards pre-pandemic trends.

Urgent Call for Renewed Action

With less than five years remaining to meet SDG target 3.1, renewed global action and sustained investment are deemed necessary to accelerate progress, strengthen health systems, and improve countries' ability to monitor and reduce maternal mortality. The urgency for global collaboration has never been greater.