6 Improve maternal health

Where are we?


A young nurse uses a monaural stethoscope to hear the unborn baby's hearbeat of an expectant mom. Nepal. Photo credit: Astha Tuladhar/UNDP Picture This

Asia and the Pacific has been slow to improve maternal health. One of two targets under the Goal 5 is to reduce the maternal mortality rate by three quarters between 1990 and 2015. Out of 31 countries for which data is available, five countries (Bhutan, Iran, Maldives, Nepal and Viet Nam) have achieved the target so far while five other countries (Bangladesh, Cambodia, China, Lao PDR, and Timor-Leste) are likely to meet the target by 2015. Other countries are off track or even regressing.

The 2012 ESCAP/ADB/UNDP Asia-Pacific MDG Report confirmed that skilled attendance at birth was the largest factor accounting for disparities across the region for attainment in reducing maternal mortality rate. The second factor was access to sanitation, followed by the per capita Gross Domestic Product.

The region’s attainment in the proportion of births attended by skilled health personnel - one of the indicators for the second target of universal access to reproductive health - gives mixed results. While 10 out of 35 countries have already achieved the target, 9 countries in the Pacific sub-region have shown reversals. Three countries are on track to achieve the target by 2015, while 13 countries are likely to miss it on their current rates of progress.

As for disparities within countries, like any other health indicators, almost all the rural-urban differences reflect differences in household wealth. Similarly, for mothers at similar wealth levels, the likelihood of a birth being attended by a skilled health professional is similar in both urban and rural areas.

The region has performed a little better as for another indicator – expanding antenatal care at least one visit. The Report shows that mother’s education had a strong bearing on the likelihood of her receiving antenatal care.

In terms of access to sexual and reproductive health care services, between 1990 and 2008, the proportion of women of reproductive age who are using (or whose partner is using) a contraceptive method rose from 58 to 67 percent in the region as a whole. Differences in contraceptive prevalence rates, however, are considerably large between sub-regions. While South-East Asia is as high as 60 percent, the Pacific had the lowest rate in the region of 38 percent.

1.44 years
remaining
until 2015

1990 2015
Targets for MDG 5
  1. Reduce by three quarters the maternal mortality ratio
    • Most maternal deaths could be avoided
    • Giving birth is especially risky in Southern Asia and sub-Saharan Africa, where most women deliver without skilled care
    • The rural-urban gap in skilled care during childbirth has narrowed
  2. Achieve universal access to reproductive health & inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health
    • More women are receiving antenatal care
    • Inequalities in care during pregnancy are striking
    • Only one in three rural women in developing regions receive the recommended care during pregnancy
    • Progress has stalled in reducing the number of teenage pregnancies, putting more young mothers at risk
    • Poverty and lack of education perpetuate high adolescent birth rates
    • Progress in expanding the use of contraceptives by women has slowed & use of contraception is lowest among the poorest women and those with no education