Pakistan among four nations driving half of global maternal deaths in 2023: UN report

ISLAMABAD: Pakistan is one of four countries that together accounted for nearly half of the estimated 260,000 maternal deaths worldwide in 2023, says a new report issued by the United Nations Maternal Mortality Estimation Inter-Agency Group.

The report, released on World Health Day, reveals that Pakistan, Nigeria, Ethiopia, and the Democratic Republic of the Congo made up 47pc of global maternal deaths, underscoring the urgent need for targeted interventions in these nations.

In Pakistan alone, an estimated 11,000 women lost their lives due to complications related to pregnancy and childbirth in 2023, representing about 4.1pc of the global burden. The country’s estimated maternal mortality ratio (MMR) in 2023 stands at 155 maternal deaths per 100,000 live births—as compared to global average of 197.

Despite a global decline of 40pc in maternal deaths since 2000, the progress in countries like Pakistan has been uneven and is now at risk of being reversed due to significant funding cuts to reproductive and maternal health services.

The report notes that humanitarian aid reductions have resulted in the closure of healthcare facilities, loss of skilled health personnel, and disruption of supply chains for life-saving medicines and equipment, particularly in fragile health systems. These setbacks are threatening maternal and newborn survival, especially in rural and conflict-affected areas where access to emergency obstetric care is limited or non-existent.

According to the report, the majority of maternal deaths in Pakistan and similar countries are caused by preventable or treatable conditions such as postpartum haemorrhage, hypertensive disorders including pre-eclampsia and eclampsia, sepsis, complications from unsafe abortions, and pre-existing diseases that are aggravated by pregnancy.

Anaemia, malaria, and non-communicable diseases also contribute significantly to maternal deaths in these settings. Many of these complications can be prevented or effectively managed with timely access to skilled birth attendants, antenatal care, emergency obstetric services, and postpartum support. However, systemic barriers such as poverty, gender inequality, and weak health infrastructure continue to hamper efforts to reduce maternal mortality.

The COVID-19 pandemic further exposed vulnerabilities in maternal health systems. In 2021 alone, an estimated 40,000 additional maternal deaths were recorded globally due to direct complications from COVID-19 and the widespread interruption of essential health services.

Pakistan was not spared, as lockdowns and healthcare disruptions led to reduced access to antenatal care and institutional deliveries, with rural women being the hardest hit.

The fact sheet accompanying the report highlights alarming disparities in maternal health outcomes between high-income and low-income countries. A 15-year-old girl in a low-income country such as Pakistan faces a lifetime risk of 1 in 80 of dying from maternal causes, compared to just 1 in 5,600 in high-income countries.

The maternal mortality rate in sub-Saharan Africa is 545 deaths per 100,000 live births—nearly nine times higher than in Central and Southern Asia, where Pakistan is located, but the South Asian region still accounted for over 22pc of all maternal deaths in 2023.

UN agencies warn that the world is off-track to meet the Sustainable Development Goal (SDG) target of reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. To achieve this goal, the global MMR would need to decline by 15pc annually—ten times the current rate of reduction.

For Pakistan, this would mean drastically increasing investments in maternal health, particularly in expanding access to skilled birth attendants, strengthening referral systems, and addressing the social determinants of health that put women at risk.

The report urges countries like Pakistan to prioritize maternal and newborn health by increasing domestic funding, restoring international aid, and investing in midwives, nurses, and community health workers. It also recommends improving access to contraception and family planning services, educating girls and women, and ensuring comprehensive reproductive health services, including safe abortion care where legal.

According to UNFPA Executive Director Dr Natalia Kanem, ensuring access to quality maternal health services is not a privilege but a fundamental right. “By boosting supply chains, the midwifery workforce, and the data needed to pinpoint those most at risk, we can and must end the tragedy of preventable maternal deaths and their enormous toll on families and societies,” she said.

The findings of the report serve as a wake-up call for policymakers in Pakistan, where maternal mortality remains a major public health challenge. As the country navigates economic difficulties and humanitarian crises, the health and survival of mothers must remain a national priority to ensure a healthier and more equitable future for all.