Montevideo, 6 November 2024. In response to the need to accelerate the reduction of maternal mortality in the Americas, especially after the setbacks caused by the COVID-19 pandemic, the Pan American Health Organization (PAHO) convened a regional workshop in Bogota, Colombia, on 21-22 October. This event focused on the need to improve the measurement and monitoring of maternal mortality, and the implementation of national and subnational strategies, in the framework of the Call to Action issued by PAHO Director, Dr. Jarbas Barbosa in June 2024.
Call to Action: Zero Preventable Maternal Deaths
The call to action places strong emphasis on strengthening primary health care (PHC) as a pillar for reducing preventable maternal deaths. The proposed strategy has six strategic lines of action and seeks to align the efforts of all countries in the region, prioritising sustainable interventions focused on equity in access to quality maternal health services.
The director of PAHO's Latin American Centre for Perinatology, Women's and Reproductive Health (CLP/WR), Dr. Suzanne Serruya, explained that 12 priority countries were identified for the implementation of the strategy: Bolivia, Brazil, Colombia, Dominican Republic, Guatemala, Haiti, Honduras, Jamaica, Mexico, Paraguay, Peru and Venezuela.
Serruya said that this strategy is a framework, but it is necessary for each country to take ownership of this document to adapt it to the needs and realities of each territory. ‘We, at PAHO, are here to accompany and support the ministries to ensure proper implementation,’ she said.
Background and challenges
According to data from the Maternal Mortality Estimation Interagency Group (MMEIG), between 2000 and 2014, the maternal mortality ratio (MMR) in the Americas experienced an annual reduction of 1.2%, significantly slower than the global average. Furthermore, between 2015 and 2020 the regional MMR increased from 58 to 68 maternal deaths per 100,000 live births, marking a worrying deviation from global trends of continued reduction.
The COVID-19 pandemic further exacerbated vulnerabilities in the region's health systems, intensifying existing disparities in access to essential maternal health services. As a result, the pandemic contributed to excess maternal mortality, disproportionately affecting women and adolescent girls who already faced significant barriers to accessing quality health care even before the crisis.
PAHO's regional advisor on maternal health, Bremen De Mucio, said it is important to focus on a rights and social justice perspective. "The vast majority of maternal deaths are preventable. It is an issue that should challenge us all and that is why it is urgent to act accordingly’.
Accurate estimates as a tool for maternal mortality reduction
A key element of working on the causes of maternal deaths is to strengthen the capacity of national teams to estimate and analyse maternal mortality more accurately.
This is often a challenge because, as more accurate methodologies become available, it is expected that more cases of maternal deaths will be identified. However, knowing exactly not only the number, but what the causes were and what could have been done differently to prevent those deaths is crucial to making real and sustained progress in reducing maternal mortality.
The head of PAHO's Health Metrics and Analysis unit, Dr. Adrienne Cox, said it is essential to have data and, above all, to know how to use that data. "In the current context, it is clear that we cannot continue to do the same thing. We have to do something different to get different results’.
Through this initiative, the aim was to strengthen health systems, improve the reliability of maternal health data and promote evidence-based interventions that lead to a sustainable reduction in maternal mortality in the Americas.
