Maternal death has been a critical aspect to consider for a plethora of governments, as well as international organizations, for decades. However, due to a number of historical factors, crucial measures to get away from the phenomenon were formulated and set at the end of the 20th century. There has been visible progress within the scope of achieving significant results in reducing maternal mortality globally since the mentioned period. Nevertheless, several issues remain unsolved, such as present inequity and inequality in preventable maternal death – they are to be overcome. It seems reasonable to claim that authorities and international organizations have the necessary resources and capacity to resolve the problem. Hence, in the framework of the international governance lens, discussions on the alienation of global inequity within the prevention of maternal deaths are relevant and reasonable to provide.
At the beginning of the 21st century, the Millennium Declaration defined fundamental values that are vital to establishing appropriate international relationships. The Millennium Development Goals provided concrete aims to realize these values globally by 2015 (UN documentation, no date). The fifth goal is to improve maternal health, which, apparently, includes maternal mortality reduction. Such an approach shows that countries and the UN demonstrate a solid dedication to handling the issue. WHO defines maternal death as “the death of a woman whilst pregnant or within 42 days of delivery or termination of pregnancy, from any cause related to, or aggravated by pregnancy or its management, but excluding deaths from incidental or accidental causes” (WHO, no date, para. 2). A considerable range of factors, starting from adverse health conditions and ending with insufficient governmental policies, might lead to the lethal outcome.
After setting the fifth goal, there have been several notable achievements regarding maternal mortality reduction. WHO (2019b, para. 1) states, “between 2000 and 2017, the maternal mortality ratio (MMR, number of maternal deaths per 100,000 live births) dropped by about 38% worldwide”. The world has been facing this decline since 1990; most of the reduction took place after 2000 – the year when the Millennium Goals were accepted (The Millennium, 2015, p. 38). Such a positive shift confirms that an effective policy may contribute to reducing maternal mortality. Roos and Xylander (2016) claim that most of these deaths are preventable if sufficient antenatal and delivery care is provided. Moreover, international actors tend to attract attention to the problem with numerous initiatives, conferences, and publications.
Nevertheless, a number of substantial challenges are still occurring worldwide. The primary issue refers to global inequality in preventable maternal deaths. WHO (2019a, para. 3) notices that the latter take place in the least developed countries, “estimated at 415 maternal deaths per 100 000 live births”. The lifetime risk is “as high as 1 in 37 for a 15-year old girl in sub-Saharan Africa” (WHO, 2019a, para. 3). In contrast, if this girl lives in Australia, she has a risk of 1 in 7800. Furthermore, in 2017, Sub-Saharan Africa and Southern Asia had 86% of global maternal deaths; Southern Asia – nearly 20% (WHO, 2019a, para. 4). This tendency reveals visible inequity that is to be addressed within the international scope.
Then, there is inequality in access to maternal health care persisting in most regions. The proportion of deliveries attended by skilled health personnel in rural and urban areas varies significantly. For instance, by 2015, while in Eastern Asia, the gap was 0, in the developing regions and Central Africa, the percentage was 31 and 52, respectively (The Millennium, 2015, p. 40). What is more, there is a necessity for high-quality data on maternal deaths (WHO, 2019a; Ozimek and Kilpatrick, 2018). Such a claim founds on the fact that inappropriate reporting leads to the lack of data accuracy, which results in insufficient policies and decisions. Unfortunately, this reporting is characteristic of many developing regions today.
It should be mentioned that currently, governments are guided by some crucial and promising targets and provisions. According to WHO (2015), the UN Sustainable Development Goals (SDGs) unite countries to accelerate maternal mortality to less than 70 per 100 000 births. Then, Strategies toward ending preventable maternal mortality (EPMM) is a report that sets a direction for global aims and policies for the reduction of maternal mortality under SDGs (Ending preventable, no date). It seems apparent that authorities and international organizations have an essential foundation for dealing with the issue.
Through a governance lens, the process of preventing maternal deaths is effort- and resource-taking. Nevertheless, “maternal mortality is widely used as an indicator of a nation’s health and the quality of its medical care delivery system” (Callaghan, 2020, p. 275). Hence, globally, the extent to which these deaths are being reduced year by year determines the efficiency of healthcare systems internationally. It is vital to create appropriate conditions for bringing a new life into this world because newborns’ healthiness substantially defines the state of the art of global health in the future. The implication of the fifth Millennium Goal that is prolongated by the third SDG provides a great foundation for confidence in the birth of a child and his or her well-being further. Neonates tend to grow healthy when their mothers are beside and take care of them.
However, inequity and inequality in preventable maternal deaths hinder the realization of the above goal considerably. Global health is not a sum of the developed countries’ indicators. It is a concept that implies an international perspective on public health problems. Thus, it is vital to ensure high-quality care worldwide, creating related healthcare programs. The simple existence of these programs will not be sufficient – it is important to provide appropriate, reliable, and consistent reports on their implementation. It will help to assess real progress and upcoming challenges; as stated above, reporting is a big issue within the scope of maternal mortality. The necessary extent of transparency and accountability may be given by establishing maternal data centers that will make real-time data available, which led to significant results in the US (Ozimek and Kilpatrick, 2018). In developing countries, such centers may be financed by international organizations and other contributors.
In conclusion, the fifth goal has led to crucial achievements – the global rate of maternal mortality has reduced considerably, and many governments attract attention to the issue. Nevertheless, inequality within this problem remains unsolved – the least developed countries demonstrate indicators that are substantially worse than the developed states’ ones. International actors have the necessary capabilities to overcome such inequity, which is stated in the UN SDGs. The realization of the goal will result in the confidence to born a child and healthiness of the latter, which positively affects global health. Finally, the creation of maternal data centers worldwide might lead to reliable reporting that is among the main prerequisites for reducing maternal deaths.
Reference List
Callaghan, W. (2020). ‘Maternal Mortality’, Obstetrics & Gynecology, 135(2), pp. 274–275. Ending preventable maternal mortality. Web.
Ozimek, J. and Kilpatrick, S. (2018). ‘Maternal mortality in the twenty-first century’, Obstetrics and Gynecology Clinics of North America, 45(2), pp. 175–186.
Roos, N. and Xylander, S. (2016) ‘Why do maternal and newborn deaths continue to occur?’Best Practice & Research Clinical Obstetrics & Gynaecology, 36(1), pp. 30–44.
The Millennium development goals report(2015).
UN documentation: Development.
WHO (2015) Strategies toward ending preventable maternal mortality (EPMM).
WHO (2019) Maternal deaths decline slowly with vast inequalities worldwide.
WHO (no date) Maternal mortality ratio (per 100 000 live births). Web.