Finally, Fewer Women Around the World Are Dying from Childbirth. Now to Continue the Trend.

For decades, the maternal health community has been stuck on the number 500,000 -- the estimated number of women dying from pregnancy and childbirth each year -- a stubborn figure that keeps us up at night, that horrifies us, that refuses to budge. That changed this week.

On Monday April 12th, the Lancet published new research showing a dramatic decline in the number of women dying from pregnancy complications each year around the world -- thereby proving that investments to improve maternal health are indeed working. This is very welcome news that brings us one step closer to solving what was once perceived as an intractable problem.

The research, conducted by a team from the Institute for Health Metrics and Evaluation at the University of Washington and the University of Queensland, found a 35% reduction in maternal deaths from 526,300 in 1980 to 342,900 in 2008. That's more than 200,000 women's lives saved each year.

These findings provide much needed hope and optimism for those working to improve the health of women around the world -- people who, for decades, have pushed hard for resources for continued innovation to make high quality care available to all women -- despite the odds. The maternal health community can now better target interventions, refine and strengthen advocacy messages, develop a focused research agenda, improve measurements that track progress and ultimately, show governments, donors and supporters that their investments in maternal health pay off.

While it is clear that, globally, fewer women are dying of pregnancy-related causes each year, the study included country-specific estimates that offer a compelling view into comparative progress -- which countries are succeeding and which still face real challenges. Namely, six countries alone account for more than half of all maternal deaths (India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of Congo). China, Egypt, Ecuador and Bolivia have made notable strides. Paradoxically, several high income countries including the USA, Canada and Norway), are actually seeing increases in the number of deaths due to pregnancy related complications.

What better time than now for local and international organizations to discuss lessons learned and shared challenges -- to engage in a robust scientific conversation? What can we learn from successful countries about their ability to care for pregnant women? I was delighted to see that Mexico, where I committed over two decades of my career to improving maternal health, has made significant progress saving mothers' lives. At the same time, we need to understand why, for example, efforts in Brazil have resulted in more dramatic progress.

This report also begs for further innovations to integrate maternal health care with HIV prevention and treatment efforts. The data shows that nearly one out of every five maternal deaths can be linked to HIV, and is one more endorsement of what the global health community has been talking about for some time: If we are going to improve the health of mothers in places with high levels of HIV, specifically sub-Saharan Africa, we will need to focus attention on addressing women's holistic needs, providing high quality obstetric care and HIV services under one roof. This is especially true in places where care of any kind is hard to come by.

We have new better estimates to track what we all hope will be achievement of Millennium Development Goal Five: reduce maternal mortality by 75% by 2015. But, to make sure we get there, we need to take this exciting boon to our efforts as the roadmap it is -- showing us where more research, investment and coordination is needed.

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