A new Lancet study has been getting a lot of attention in the global health blogosphere. The article looks at maternal mortality in 181 countries, and found good news. Maternal mortality is decreasing steadily; on average the global maternal mortality rates has been falling by 1% a year.
I’m not going to get into the details here. There are some excellent discussions of this data already up on the web. The Institute for Health metrics and Evaluation, which sponsored the study, has published a good summary. Reuters took a look at the data, and Bill Easterly takes a skeptic’s perspective on the new numbers at Aid Watch.
Reading the study myself, I was struck by two things. First of all, there are a lot of low cost ways to reduce maternal mortality. China, Egypt, Ecuador and Bolivia all made substantial strides in saving mother’s lives even though their health budgets are limited. China, in particular reduced maternal mortality rates from 165 per 100,000 to 40 per 100,000 over 30 years.
When you are dealing with basics like getting women to give birth with a trained attendant, or at a facility instead of at home, you can drive rapid decreases in maternal mortality. It’s not simple, but it’s understandable. We know how to protect mothers in low –income countries. The key is to find the resources and the political will.
On the other end of the income distribution, the problems are far more difficult to solve. Maternal mortality rates in Canada, Norway, and the US are too high for countries in the wealthy world. We know how to prevent the most basic problems of pregnancy. We know a lot less about how to prevent the kind of complicated issues that beset wealthy countries: premature births, mostly, but also maternal diabetes and heart disease.
Maternal health is always a good investment. Aside from the initial benefit of saving mothers and babies, the loss of a mother has a devastating lifelong impact on her surviving children. This new study, though, reminds us that it’s an especially good invest in the poorest countries. Small increases in funding have a powerful impact. Over half of recorded maternal deaths were in six countries: India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo. Now is the time to invest in those mothers.