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MDG Goal 5: Improve maternal health

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The key interventions for improving maternal health include increasing access to skilled birth attendance, combined with prompt referral for cases with complications (including caesarean section free of charge); scaling up emergency obstetric and newborn care (EmONC); strengthening family planning including reducing pregnancy in adolescents; and empowering women, families, and communities to make timely decisions.[1] [2] Coverage of these key interventions in order to achieve MDG5 is still low. In 2008, less than 50% of women received skilled care during childbirth. Eight countries had more than 80% of births attended by skilled health personnel between 2000 and 2009. The average caesarean section coverage in the Region is 3.6%, below the recommended figure of 5% - 15%.[3] From 2000 to 2010, the regional average percentage of women who received antenatal care from skilled health personnel at least once was 74% and at least four times during pregnancy was 44%. There remains a continuing unmet need for family planning as 24.8% of women in the Region wanting to delay or stop childbearing were not using any family planning method.[4] Eighteen countries are implementing the WHO Reproductive Health Strategy to accelerate progress towards the attainment of international development goals and targets related to reproductive health.

Progress on Target 5A:[5]

The estimated maternal mortality ratio in the Region was 620 per 100 000 live births in 2008.[6] Equatorial Guinea and Eritrea are on track to achieve this target; 33 countries are making progress although it is insufficient; and seven countries have made no progress (Figure 2).

Figure 2: Maternal mortality ratio[7] (per 100 000 live births) in 2008 and MDG target in the African Region

MDG5 MMR.jpg

Progress on Target 5B:[8]

Between 1990 and 2008, there was a 25% increase in access to contraceptives among currently married women. Contraceptive prevalence in countries ranged from 2.8% to 75.8% between 2000 and 2010, showing a little progress towards this target.

  1. Cleland J, et al. Family planning: the unfinished agenda. Lancet. 2006 Nov 18;368 (9549):1810–27.
  2. Conde-Agudelo Agustin and Jose M. Belizan, Maternal morbidity and mortality associated with inter-pregnancy interval: cross sectional study, BMJ, 2000; 321:1255–1259 (18 November) shows that there is a strong relationship between birth intervals and maternal mortality and morbidity.
  3. Count Down Report, 2008.
  4. World Health Statistics 2011, WHO, Geneva, Switzerland, 2011.
  5. MDG Target 5A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio (MMR).
  6. Trends in Maternal Mortality: 1990 to 2008; Estimates developed by WHO, UNICEF, UNFPA and World Bank; WHO, 2010.
  7. Data source: Trends in Maternal mortality:1990 to 2008: Estimates developed by WHO, UNICEF, UNFPA and the World Bank, WHO, 2010 and WHO, World Health Statistics 2011, Geneva, World Health Organization 2011. Countries with MMR≥100 in 1990 are categorized as “on track or with sufficient progress” if there has been 5.5% decline or more annually; “medium progress” if MMR has declined between 2% and 5.5%; making “some progress” if MMR has declined by less than 2% annually; and having “no progress” if there has been no decline in MMR. Botswana and Mauritius with MMR<100 in 1990 are not categorized. No trend data available for Sao Tome and Principe and Seychelles.
  8. MDG Target 5B: Achieve, by 2015, universal access to reproductive health.