Maternal health

Fact sheet

Key facts

• In 2010, 287 000 women in the world died during and following pregnancy and childbirth.
• Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy. Other complications may exist before pregnancy but are worsened during pregnancy.
• The major complications that account for 80% of all maternal deaths are: severe bleeding, infections (usually after childbirth), high blood pressure during pregnancy (pre-eclampsia and eclampsia) and unsafe abortion. The remainder are caused by or associated with diseases such as malaria, and AIDS during pregnancy.
• 99% of all maternal deaths occur in developing countries.
• Maternal mortality is higher in women living in rural areas and among poorer communities.
• Young adolescents face a higher risk of complications and death as a result of pregnancy than older women.
• Skilled care before, during and after childbirth can save the lives of tens of thousands of women and newborn babies.
• While standards of antenatal care have risen in many parts of the world during the past decade, only 46% of women in low-income countries benefit from skilled care during childbirth.

The situation

• Within the framework of the Millenniumm Development Goals (MDGs), maternal health is an important concern for the Ministry of Health and the Government of Viet Nam.
• Viet Nam is also committed to the United Nations Global Strategy for Women's and Children's Health, aimed at saving the lives of more than 16 million women and children over the next four years.
• Since 1990, maternal mortality has decreased in Viet Nam and the country is on track to achieve MDG5 (reducing maternal mortality by three quarters between 1990 and 2015).
• Maternal health and access to reproductive health services have steadily improved in Viet Nam over the last two decades.
• According to the Ministry of Health (MOH), the maternal mortality ratio (MMR) declined from 200 per 100,000 live births in 1990 to 80 per 100,000 live births in 2005, and is currently estimated to be 65 per 100 000 live births.
• Childbirths attended by trained health workers increased from 85 % in 2000 to 94.7 % in 2008.

Challenges

• Greater resources need to be allocated to maternal and reproductive health and should target the most vulnerable groups.
• Cost-effective interventions exist and most of them can be delivered in low-resource settings. The issue is how to scale up these interventions and reach the most disadvantaged and marginalized people.
• There are large disparities between socioeconomic groups. A WHO-supported study showed that the maternal mortality ratio in the Northern Uplands, a mainly poor region, was almost 10 times higher than in the more prosperous Red River Delta and south-east regions.
• While antenatal care coverage is more than 90%, a pregnant woman in the Northern or Central Highlands is much less likely than a woman in the richer regions to receive antenatal care and tetanus toxoid vaccinations.
• Three broad areas need to be improved if Viet Nam is to achieve further progress in maternal health:
• Availability of skilled birth attendants and comprehensive emergency obstetric care services, particularly in mountaneous areas;
• Quality of reproductive health services and competencies of health providers and managers to provide the full range of recommended interventions during pregnancy, childbirth and the postpartum period;
• Increasing knowledge of women, families and communities on maternal health and nutrition, on normal and danger signs during pregnancy, childbirth and the postpartum, and on the benefits of antenatal care, skilled birth attendance and postnatal care.

WHO's response

• The National Plan on Safe Motherhood and Newborn Care 2011-2015, developed with WHO's support, has set an ambitious goal of reducing the maternal mortality ratio (MMR) from 68 per 100,000 live births in 2010 to 58 per 100,000 live births in 2015.
• WHO, in collaboration with UN partners and the World Bank, supports the Ministry of Health in fulfilling the commitments to the UN Global Strategy for Women's and Children's Health and in implementing the recommendations of the United Nations Commission on Information and Accountability for Women's and Children's Health.
• WHO provides technical support to the Ministry of Health to:
• Strengthen policies for improving access and quality of maternal and emergency obstetric care services.
• Update and disseminate National Standard Guidelines on Reproductive Health Services, based on evidence.
• Improve monitoring and evaluation of safe motherhood and newborn care programs and services.
• Develop and implement a maternal mortality audit system.
• Develop and implement the National Plan on Safe Motherhood and Newborn Care 2011-2015 and the National Plan for Skilled Birth Attendance 2011-2015
• Strengthen the capacity of healthcare providers and managers to plan, implement and monitor safe motherhood programmes.