Uneven progress is occurring toward global targets for reducing maternal and newborn mortality and stillbirths at the regional and country level, according to a report that Countdown to 2030 and partners have released as part of the AlignMNH opening forum. However, all the world’s regions have made progress in the three indicators since the year 2000, with the slowest pace of change in sub-Saharan Africa.
“One third of 130 low- and middle-income countries had reached the Sustainable Development Goal and Every Newborn Action Plan 2030 targets for maternal mortality, stillbirth rates and neonatal mortality, and another 19% have the three targets within reach if sufficient investment are made in the current decade,” the report’s authors wrote. “The remaining 62 countries are still far from the 2030 targets, sometimes on one or two of the three indicators, but mostly on all three. Among those countries, 43 are located in sub-Saharan Africa. A major integrated national and international effort is required to rapidly reduce maternal and neonatal survival, and stillbirth rates in these countries, to reach even the vicinity of the targets by 2030.”
The Sustainable Development Goals target for maternal mortality is 70 deaths per 100,000 live births globally, with no country above 140, and for neonatal mortality it is 12 per 1,000 live births; for stillbirths, the Every Newborn Action Plan goal is 12 per 1,000 births. While most low- and middle-income countries have set targets to reduce maternal and newborn mortality, less than half have set target for stillbirth reduction, the report indicates.
All women-baby dyads should receive at least (1) four antenatal care visits, (2) institutional delivery care, and (3) postnatal care visit within two days for mother or baby. The report analyzed data from 88 countries with recent national surveys and found that the median of all countries was that only 57% of women-baby dyads received all three types of care. This indicator showed wide variation between countries. It also showed tremendous within-country variation by household wealth: among the poorest 10% only 40% received all three types of care, while among the richest 10%, 75% received all three.
The report also identified gaps in quality of antenatal coverage in low and middle countries, despite policies that specify the content of antenatal care. Most low and middle income countries have policies or guidelines in place requiring maternal and neonatal death reviews; 47% of countries also mandate review of stillbirths.