Maternal Health an Executive Summary for The Lancet’s Series

The Lancet. Maternal Health an Executive Summary for The Lancet’s Series. 2016

The past quarter century has delivered progress for some women and their newborn babies. Maternal deaths globally have fallen by nearly half (44%) since 1990, and use of maternity services has increased markedly. At the same time, the Millennium Development Goal (MDG) for maternal health fell far short of achievement. Some countries and groups of women saw little or no progress, despite significant global political attention on maternal health. In sub-Saharan Africa, a woman’s lifetime risk of dying in pregnancy or childbirth remains an appalling 1 in 36 compared with 1 in 4 900 in high-income countries.

Every woman, every newborn, everywhere has the right to good quality care. This is the guiding message of the 2016 Lancet Maternal Health Series—the first such series in a decade of change. The Series shines a light on the causes (see figure 1), trends, and prospects for maternal health in the current era of rapid demographic, epidemiological, and socioeconomic transition. It analyses experiences of the past 25 years, and exposes the growing threat to progress caused by poor quality care and inequity of access. Since 1990, the gap between the group of countries with the highest level of maternal mortality and the group with the lowest has doubled in size. With 210 million women becoming pregnant and the delivery of 140 million newborn babies each year, it is urgent to improve the quality of care and reduce disparities in access, so securing future economic and social development and supporting the vision of the 2030 Sustainable Development Goals (SDGs) and the Global Strategy for Women’s, Children’s, and Adolescents’ Health.

The right to good quality, woman-centred maternal health care is universal. This Series presents a truly global perspective—reporting on experiences from across all regions. For women using services, some receive excellent care but too many experience one of two extremes: too little, too late or too much, too soon. Both extremes represent maternal health care that is not grounded in evidence. And other women receive no care at all.

In high-and middle-income countries, and in better-off groups in low-income countries, there is a growing risk of over-medicalisation of normal pregnancy and birth, with the routine use of interventions unsupported by evidence. Facility-based births continue to rise, but maternity care that is too much, too soon may cause harm, raise health costs, and contribute to a culture of disrespect and abuse.

At the same time, poor quality care that is too little, too late jeopardises the health of women and their newborn babies, whether in sparsely-populated rural areas, dense urban centres, or in settings marked by environmental or political fragility. Furthermore, despite the increases in maternity care coverage in the past 25 years, an estimated quarter of pregnant women still do not access skilled care at birth.

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