The improvement of maternal health worldwide is one of the Millennium Development Goals (MDGs) committed to by the international community in 2000. To achieve this, health officials recommend an increase in the quality of health care for pregnant women, in the form of improved access to ante-natal care, a higher number of births attended by skilled medical personnel, and better and more affordable medical facilities.
Improvements in these areas, among others, should lead to a considerable reduction in maternal mortality rates, which the world has pledged to reduce by three quarters by 2015. However, reliable estimates of maternal mortality are often difficult to determine, due to under-reporting.
Most sources, however, agree that the number of women dying due to pregnancy or childbirth worldwide exceeds 500,000 per year, and that the problem is most desperate in sub-Saharan Africa, where maternal death rates are said to be as much as 1000 times higher than in high-income countries, according to the World Health Organisation (WHO).
Maternal mortality is a very serious problem in Chad, which has one of the top 10 highest maternal mortality rates in the world. Its comparatively large size and dispersed population makes it difficult for women in rural areas to gain access to skilled medical facilities, and most of its impoverished population cannot afford adequate medical treatment in any case. Additionally, many maternal deaths go unreported, making it difficult to even diagnose the scope of the problem.
Maternal Health in Chad
Estimated maternal mortality rate 1995: 1500/100,000 (Source: UNICEF)
Estimated maternal mortality rates 2000: 1100/100,000 (Source: WHO)
Births Attended by Skilled Health Personnel (2000): 16% (Source: UNICEF)
Unlike Honduras, Chad has not undertaken what is known as a RAMOS survey - "longitudinal" studies that allows scientific comparison of figures over time.
While still possessing one of the highest rates of maternal mortality in Central America, Honduras has recently taken steps to improve its maternal health conditions.
Maternal Health in Honduras
Estimate in 1995: 220/100,000 (Source: UNICEF Statistics)
Estimate in 2000: 110/100,000. (Source: WHO)
Births Attended by Skilled Health Personnel (1996): 54% (Source: UNICEF)
Since 1990, the government implemented initiatives to provide better ante-natal care for pregnant women, as well as provide medical training to Traditional Birth Attendants (TBA's) and faster and more affordable methods for women to reach medical facilities in case of serious complications. Methods of monitoring rates of pregnancy and maternal mortality have also improved.
Due to these initiatives, maternal mortality rates have been reduced by an estimated 38-41%. The most significant reduction occurred between 1990 and 1997, when Honduras recorded one of the most dramatic declines in maternal mortality ever documented in such a short time span in the developing world, dropping 41 percent from 182 to 108 deaths per 100,000 births. This is according to Professor Jeremy Shiffman, citing Meléndez JH, Ochoa JC, Villanueva Y. 1999. "Investigación sobre mortalidad materna y de mujeres en edad reproductiva en Honduras: informe final correspondiente al año 1997" Tegucigalpa, Honduras.