Nearly two-thirds of all maternal deaths worldwide occur in countries marked by conflict or fragility, a report released on Tuesday by the World Health Organisation and partners has shown.

The brief was produced by WHO and an inter-agency group that includes the UN agencies for development, UNDP, sexual and reproductive health, UNFPA, and children, UNICEF, as well as the World Bank.

The report said the risk of a woman who lived in a country affected by conflict dying due to maternal causes was around five times higher for each pregnancy she undergoes compared to her peers in stable countries.

According to the report, in 2023 alone, an estimated 160,000 women died from preventable maternal causes in fragile and conflict-affected settings, which is six in 10 maternal deaths worldwide.

This is in spite of these countries accounting for only around one in 10 of global live births, the WHO-led report said

The new technical brief offered an analysis as to why pregnant women living in certain countries are more likely to die in childbirth.

It also confirmed what many practitioners see on the ground: crises create conditions where health systems cannot consistently deliver lifesaving maternal care.

“Indeed, the intersection of gender, ethnicity, age and migration status can increase the risk women and girls face who are both pregnant and living in fragile contexts,” it said. “The disparity of risk is stark. A 15-year-old girl living in a country or territory affected by conflict in 2023 had a one in 51 lifetime risk of eventually dying from a maternal cause.”

It added, “This is compared with a one in 79 risk in a country or territory affected by institutional and social fragility, and one in 593 for a 15-year-old girl living in a relatively stable country.”

The report aligned the latest maternal mortality ratio estimates with a country’s conflict-affected status or fragility.

Countries classified as conflict-affected had an estimated maternal mortality ratio of 504 deaths per 100,000 live births, while in countries considered institutionally and socially fragile, it was 368. In contrast, countries outside both categories saw a much lower ratio of 99.

These findings deepened the picture provided in last year’s maternal mortality estimates for 2000 through 2023. The maternal mortality estimates showed that global progress had stalled and that maternal mortality remained staggeringly high in low-income and crisis-affected settings, which spurred this further analysis.

The publication also offered case studies of how frontline teams are striving to maintain maternal health services amid instability.

This is with solutions showing that, even under extreme pressure, innovative approaches can protect maternal health.

(NAN)