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Despite modest progress, particularly in Asia, the global maternal mortality toll remains stubbornly stable due to a lack of financial resources and political will, it said.
More than 99% of the estimated 536 000 maternal deaths worldwide in 2005 occurred in developing countries, half of them in sub-Saharan Africa, it said in a report entitled "Progress for Children: A Report Card on Maternal Maternity".
"One of the critical bottlenecks has always been access to highly skilled health workers required to deliver emergency obstetrical care, particularly caesarian sections," said Peter Salama UNICEF's chief of health.
Around 50 million births in the developing world, or about four in 10 of all births worldwide, are not attended by trained personnel, according to the report. Hemorrhaging is the leading cause of maternal death in Africa and Asia, causing one in three deaths, it said. Infections, hypertensive disorders, complications of abortion, obstructed labor or HIV/Aids are other causes.
Niger the riskiest for giving birth
Such complications can be easily treated in a health system whose facilities are staffed with skilled personnel to handle emergencies around the clock, but disparities persist, it said.
"The lifetime risk of maternal death in the developing world as a whole is one in 76, compared with one in 8 000 in the industrialised world," UNICEF said.
The riskiest place to give birth is Niger, where the risk of dying in pregnancy or childbirth over the course of a woman's lifetime is one in seven, it said. In Sierra Leone it is one in 8.
But developing countries including Sri Lanka and Mozambique have succeeded in reducing maternal mortality rates, it said.
A combination of family planning, training skilled birth attendants, emergency obstetrical care and post-natal care is the key to reducing maternal mortality, according to the agency.
At the current average reduction rate of less than one percent a year, the world will miss the goal of reducing maternal mortality rates by 75% between 1990 and 2015, to less than 150 000, one of the Millennium Development Goals, it said.
"The time is right. We now know exactly what to do for maternal mortality reduction to make this one of the next big issues in global health," Salama said.
$10 billion needed to fight problem
Programmes to combat three major epidemics - HIV/Aids, tuberculosis and malaria - now receive the required international attention and billions in funding, he said.
"But maternal mortality and child mortality do not yet receive the attention that the scale of the problem deserves," he said. An additional $10 billion would be needed each year to combat both child and maternal mortality, according to Salama.
UNICEF said last week that more than 9 million children died before their fifth birthday in 2007, down slightly from a year before, but a huge gap remains between rich and poor countries. – (Reuters Health, September 2008)
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