Guyana among regional countries with highest maternal mortality rates

–unlikely to meet Millennium Development Goal

It is unlikely that any country in the Americas or the Caribbean will achieve the Millennium Development Goal (MDG) 5A, which calls for the reduction of the maternal mortality ratio by three quarters between 1990 and 2015.

Last December, Minis-ter of Health Dr Bheri Ramsaran had indicated that Guyana was “doing fairly well and we are on our way to achieving the Millennium Developmen-tal Goal (MDG).”

However, this is not the case as the country is among five in the Carib-bean and the Americas with the highest rates of maternal mortality, according to the latest report.

The report, ‘Trends in Maternal Mortality Esti-mates 1990 to 2013’, reveals changes in maternal mortality worldwide and by region and country. It was produced jointly by the World Health Organ-isation (WHO), UNICEF, the United Nations Pop-ulation Fund (UNFPA), the World Bank and the United Nations Population Divi-sion.

The report includes new data not captured in the last set of global estimates in 2012, as well as improved methods of estimating births and all female deaths.

“However, at current trends, most countries will not achieve the MDG target of a 75% reduction in MMR from 1990 to 2015. An average decline of 5.5% or more every year since 1990 is needed to meet the target on time,” it said.

The maternal mortality rate is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes). It includes deaths during pregnancy, childbirth, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, for a specified year.

MDG 5A calls for the reduction of maternal mortality ratio by three quarters between 1990 and 2015.

According to the report, it has been a challenge to assess the extent of progress due to the lack of reliable and accurate maternal mortality data, particularly from developing country settings where maternal mortality is high.

It said the five countries of the Americas with the lowest maternal mortality rate (MMR) are: Canada (11 per 100,000), Uruguay (14), Chile (22), the United States (28) and Bahamas (37). The five with the highest MMR are Haiti (380), Guyana (250), Bolivia (200), Guatemala (140) and Suriname (130).

The 19 countries that will achieve MDG 5A by 2013 are: Belarus (96% reduction in MMR); Maldives (93%); Bhutan (87%); Cambodia (86%); Israel (84%); Equatorial Guinea (81%); Poland (81%); Lao People’s Democratic Republic (80%); Romania (80%); Bulgaria (78%); Estonia (78%); Timor-Leste (78%); Eritrea (77%); Cabo Verde (77%); Latvia (77%); Oman (77%); Lebanon (76%); Nepal (76%) and Rwanda (76%).

It said that a further 63 countries are characterised as ‘making progress’, while 13 countries have made ‘insufficient progress.’ There are two countries that have made ‘no progress.’

The new data in the report show a 45% reduction in maternal deaths since 1990.

It also reported an estimated 289,000 women died in 2013 due to complications in pregnancy and childbirth, down from 523,000 in 1990.

But while there has been a reduction, the report said faster progress is needed even though the global reduction of MMR has accelerated, with a 3.5% annual decline from 2000 to 2013, as compared with 1.4% between 1990 and 2000.

It said that the sub-Saharan Africa region alone accounted for 62% (179,000) of global deaths followed by Southern Asia at 24%. At the country level, the two countries that accounted for one third of all global maternal deaths are India at 17% (50,000) and Nigeria at 14% (40,000).

Eleven countries that had high levels of maternal mortality in 1990 (Bhutan, Cambodia, Cabo Verde, Equatorial Guinea, Eritrea, Lao People’s Democratic Republic, Maldives, Nepal, Romania, Rwanda, Timor-Leste) have already reached the MDG target of a 75% reduction in maternal mortality. Based on these latest trends, however, many low and middle-income countries will not achieve this goal.

Sub-Saharan Africa is still the riskiest region in the world for dying of complications in pregnancy and childbirth.

The ten countries that carry most of the burden and account for about 60% of global maternal deaths are: India (50,000), Nigeria (40,000), Democratic Republic of the Congo (21,000), Ethiopia (13,000), Indonesia (8,800), Pakistan (7,900), United Republic of Tanzania (7,900), Kenya (6,300), China (5,900) and Uganda (5,900).

Somalia and Chad have the highest lifetime risk of maternal death, where women face a 1 in 18 and 1 in 15 risk, respectively.