Maternal mortality is an important indicator of a woman’s health status and of health system’s performance. The Sustainable Development Goals set a target of global maternal mortality ratio to 70 per 100 000 live births by 2030.
In LAC, maternal mortality ratio (MMR) averaged 72 deaths per 100 000 live births in 2023, substantially higher than the average of 10 deaths per 100 000 live births in OECD countries (Figure 3.19, left panel). Estimates show Chile with one of the lowest MMRs at 10, while Haiti had one of the highest at 328, followed by Venezuela and Bolivia with 227 and 146, respectively. Despite high rates in certain countries, a reduction of ‑33.3% in maternal mortality has been achieved in the LAC region between 2000 and 2023, below the reduction in OECD countries of ‑37.6% in the same period. In Nicaragua, Paraguay, Suriname and Chile MMR decreased by around 70%. Nevertheless, during the same period MMR increased in 5 countries, with Venezuela (163%), Dominican Republic (64.7%), Jamaica (58.9%) and Bahamas (48.1%) experiencing increases of more than 40% (Figure 3.19, right panel).
Across 27 LAC countries, maternal mortality tends to be inversely related to the coverage of skilled birth attendance, however other factors might also influence MMR (Figure 3.20). Twelve countries had a higher coverage of skilled birth attendance than the LAC average and a lower maternal mortality ratio (top left quadrant). The converse was true in 4 countries (bottom right quadrant). However, in Cuba and Jamaica, skilled birth attendance coverage was the highest, at 100%, which is 3% above the LAC average but they also had a high MMR, over 170, meaning more than double the LAC average. This may suggest challenges with quality of care. Most countries (20) had more than 97% of births attended by skilled health professionals. However, substantial gaps in skilled birth coverage remain in Bolivia (72%), Mexico (88%) and Paraguay (91%), all bellow the LAC27 average.
Higher coverage of antenatal care (at least four visits) is slightly inversely correlated with MMRs (Figure 3.20). The top left quadrant of the graph, which represents higher than LAC average antenatal care coverage and lower than LAC average maternal mortality rates includes 9 of the LAC22 countries. Because maternal mortality rates have decreased significantly across the LAC region overall, they may no longer be as sensitive to variables that previously showed strong associations. Bolivia and Jamaica have the highest MMR, above 140 deaths per 100 000 live births and more than double the LAC22 average of 62, with antenatal care coverage below 85%. This suggest that these countries could reduce their MMR by increasing the number of antenatal care visits. However, it is important to consider the experience of countries such as Argentina, Antigua and Barbuda and Grenada, which have achieved low MMR despite comparatively lower antenatal coverage. This suggests that additional factors, such as ensuring maternal health access for all women, improving its quality, and empowering women and communities to exercise their sexual and reproductive rights, may have a positive impact on maternal health and the prevention of avoidable maternal mortality.
Risk of maternal death can be reduced through family planning, better access to high-quality antenatal care, and delivery and postnatal care by skilled health professionals. Addressing disparities in the provision of these essential reproductive health services to underserved populations must be included in any strategy. Furthermore, the broad health systems strengthening and universal health coverage agenda, along with multisectoral action (e.g. women’s education, tackling violence) are crucial to reducing maternal deaths in the LAC region (WHO et al., 2018[1]).
