Millennium Development Goal #5

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Main Targets

Progress Report: Reduce by three quarters the maternal mortality ratio.

Progress Report: Achieve universal access to reproductive health.






For the majority of women in the world, pregnancy and delivery are major health risks. The death or disability of a wife or mother in developing regions often times paralyzes the entire family and community unit, yet all of the risks presented by pregnancy are largely avoidable. Currently, this MDG is largely off track, with the highest risk of maternal mortality concentrated in Sub-Saharan Africa.  The largest cause of maternal death worldwide is obstetric hemorrhage, with even higher risks to very young women, very old women, women who have had multiple births close together and poorly educated women.

The most effective solution lies in skilled attendance during child birth, and at least 4 antenatal visits to ensure the mother and child’s health. In 2009, 81% of women in developing regions had a skilled attendant present during delivery, allowing risks such as HIV transfer from mother to baby and complications to be managed. Family planning is also essential, but making slow progress. Currently there are 120 million women in a union or married who would like to delay pregnancy but do not have access to any facilities, with the highest concentration of these women being found in the Caribbean and Sub-Saharan Africa.

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Reduce by three quarters the maternal mortality ratio.

Progress Report

  • Despite progress being made, this target is far from being reached: developing regions maternal death rate on a whole has dropped by 34% between 1990 and 2008 – equaling out to about 440 maternal deaths per 100,000 live births to 290 maternal deaths.

  • Between 1990 and 2008, 90 countries showed declines in their mortality ratios of 40% of more, with the biggest gains being made in Eastern Asia, Northern Africa, South-East Asia and South Asia.

  • Sub-Saharan Africa and South Asia made up for 87% of worldwide maternal deaths in 2008. South Asia has been making steady progress with a 53% decline in maternal deaths between 1990 and 2008, and Sub-Saharan Africa falling by 26%.


  • Obstetric hemorrhage is the largest cause of maternal death, followed by eclampsia, sepsis, complications from unsafe abortions and indirect causes like HIV/AIDS and malaria.
  • There is an increase in maternal deaths when the mother has had: many children, is very old or very young, poorly educated and/or subject to gender discrimination.

The Role of Health Care Professionals

  • Maternal death is largely avoidable, with the majority of causes of death being easily curbed with the help of skilled health attendants.
  • Midwives, nurses and doctors can remedy problems as they occur and call on higher level help if needed. They can also pre-determine if there might be problems during delivery, allowing women to get to a hospital, which are sometimes hours from their homes.
  • Poor, rural women are the most at risk during pregnancy and delivery, especially those who live in areas that suffer from an already low number of skilled health workers.
  • In developing regions overall, the number of births attended by a health care professional rose from 55% in 1990 to 65% in 2009. North Africa (74%) and South-East Asia (63%) have the most attended births by a skilled health worker on average within developing regions, with skilled attendance coverage still low in Sub-Saharan Africa and South Asia
  • Google Interactive Graph on the Number of Skill Attended Births  - Watch Now

 Adolescent Pregnancy

  • Very young mothers carry more complications during pregnancy than their older counterparts, with the maternal mortality date the highest in adolescents and increasing with every pregnancy. In almost all regions, teen pregnancy rates are down (births per 1,000 women aged 15-19) went down between 1990 and 2000 but has since seen progress stall.
  • Sub-Saharan Africa has the highest birth rate among adolescents with 122 births per 1,000 women aged 15-19, and has changed very little since 1990.
  • Overall, across developing regions, women are having fewer children. However, in regions that have seen fertility rates decrease, adolescent fertility remains high.
  • Global population estimates put women 15-19 at almost 300 million worldwide – the fastest growing in Sub-Saharan Africa and least developed countries where adolescent pregnancy and pregnancy risks are the highest. 

Achieve universal access to reproductive health.

Progress Report

  • Basic antenatal care (care during pregnancy) provides women with a range of services which include: nutritional advice, warning signs on delivery issues and allowing treatment to stop transfer of diseases like HIV to their babies.
  • Globally, since 1990 the number of women receiving antenatal care has increase by a notable amount. In developing regions the number of women who were seen by a trained health specialist during pregnancy went up from 64% in 1990 to 81% in 2009.
  • The recommended amount of visits for antenatal care is put at 4 visits, to ensure any complications are caught and managed appropriately. In the developing regions, this number is still low but making progress – from 35% in 1990 to 51% in 2009.


  • There has been increased access to safe, affordable and effective methods of contraception worldwide which contributes to maternal and infant health by preventing unintended pregnancy, closely spaced pregnancies and pregnancy in very young mothers.
  • By 2008, more than half of all women 15-49 in a union or married were using some kind of contraception - in all but two regions, Oceania and Sub-Saharan Africa. Overall progress slowed down between 2000 and 2008 in almost all regions.
  • Sub-Saharan Africa, who currently has the highest maternal mortality rate and limited access to skilled care during pregnancy, also has the lowest level of contraceptive prevalence (22%) with little progress since 2000.
  • Globally, 120 million women aged 15-49 either married or in a union have an unmet need for family planning – meaning they would like to use contraceptives to either avoid or delay pregnancy but cannot find an attainable source to do so.
  • This unmet need, which sits at a fairly high level, has stayed mostly the same since 2000, and is the highest in the Caribbean and Sub-Saharan Africa. It is estimated that a quarter of the women of child bearing age who are in a union or married would like access to health services.
  • Interestingly, the unmet need for family planning is found in the same areas that had a high prevalence of contraceptive use (upwards of 60%). It is projected that one out of ten women have unmet family planning needs in areas like North Africa and South-East Asia, which has wide contraception use.
  • The use of contraception is much lower in adolescents than that of all women of reproductive age (25%).
  • Developing regions overall are seeing more women reaching reproductive age (up by 50% since 1990) demands that more health services and clinics must be made available for women to gain access to contraceptives if they choose to use them.
  • It is estimated that by meeting the unmet needs of women who would prefer to delay or avoid having children could cut maternal deaths by one third.  

  • The World Health Organization graph on the unmet need for family planning - Read Now  


  • Funding in necessary to achieve this MDG. The official development assistance for family planning has gone down between 2000 and 2008, from 8.2% to 3.2%. There is now less money available than there was in 2000, despite the growing need.

Programs That Work

  • Mobile health units allow health professionals to reach rural areas, meeting pregnant women within their own community. In Pakistan, mobile health units were introduced in 2005 and had 85000 patients by 2008. The clinics provided guidance for delivery, helped with post miscarriage complications and made referrals for caesarean section. This program allowed for a skilled attendant to be present for 43% of antennal checkups for women in remote areas, 12% higher than the national average. 






“The Millennium Development Goals Report 2011”, the United Nations, June 2011.

“We Can End Poverty 2015 – Fact Sheet”, UN Department of Public Information, September 2010.

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