In 2000 a number of
world leaders committed to the United Nations Millennium Declaration (UNMD).
This declaration set out eight targets, known as the Millennium Development
Goals (MDGs), to achieve by 2015. Included in these goals was the aim to
improve maternal health by reducing the maternal mortality ratio (MMR, number
of maternal deaths per 100,000 live births) globally by 75% from 1990 to 2015.
An ambitious goal, considering a reduction of just 13% had occurred from 1990
to 2000. Maternal mortality is defined as 
. The major causes of maternal mortality include haemorrhages, sepsis,
pre-eclampsia and unsafe abortion practices. Many of the causes of death are
preventable or treatable but due to inequity of access to contraception,
antenatal care, skilled care during childbirth and adequate care post partum women
fall victim to these complications, particularly in the developing world where
the vast majority of maternal deaths occur. It is clear considerable progress
has been made since the MDGs came into being with MMR estimated as 216 in 2015
from **** in 2000, an admiral reduction but still falling short of the 75%
hoped for, perhaps reflecting an unrealistic goal to begin with. Of note
however is the acceleration in the reduction of MMR rates from 2000 to 2015,
almost double the estimated average annual decline from 1990 to 2000, prompting
optimism for future progress. (trends in maternal mortality doc p  20)

The global reduction in
MMR from 2000 to 2015 though impressive does not reflect the achievements of
individual countries, with those making little or no progress towards reducing
MMR of greatest concern. The reduction of an MMR which is already low can be
difficult but most countries with low rates in 2000 reduced their MMR further,
while 26 others with higher rates made little progress. While the WHO deems the
current data on MMR to be the most accurate to date care must be taken when
interpreting changes in MMR as just 50% of countries provide maternal mortality
data, which in many cases is incomplete. Nigeria, for example appears to have a
reduction in MMR from 2000 to 2015 however due to uncertainty in the data there
is a high possibility no progress has been made. Disparities within countries
can also be masked by the data e.g***marginalised groups. ????? those areas
where women most at risk not accounted for? With such disparities and questions
over the data it must be considered how much is not accounted for? The MMR
calculated for Sierra Leona for example, using new more accurate data showed
maternal mortality rates higher than previously estimated. Though it appears
maternal mortality is reducing at a global level we must be cautious in
interpreting the data available and be aware this may not reflect individual In 2000 a number of
world leaders committed to the United Nations Millennium Declaration (UNMD).
This declaration set out eight targets, known as the Millennium Development
Goals (MDGs), to achieve by 2015. Included in these goals was the aim to
improve maternal health by reducing the maternal mortality ratio (MMR, number
of maternal deaths per 100,000 live births) globally by 75% from 1990 to 2015.
An ambitious goal, considering a reduction of just 13% had occurred from 1990
to 2000. Maternal mortality is defined as 
. The major causes of maternal mortality include haemorrhages, sepsis,
pre-eclampsia and unsafe abortion practices. Many of the causes of death are
preventable or treatable but due to inequity of access to contraception,
antenatal care, skilled care during childbirth and adequate care post partum women
fall victim to these complications, particularly in the developing world where
the vast majority of maternal deaths occur. It is clear considerable progress
has been made since the MDGs came into being with MMR estimated as 216 in 2015
from **** in 2000, an admiral reduction but still falling short of the 75%
hoped for, perhaps reflecting an unrealistic goal to begin with. Of note
however is the acceleration in the reduction of MMR rates from 2000 to 2015,
almost double the estimated average annual decline from 1990 to 2000, prompting
optimism for future progress. (trends in maternal mortality doc p  20)

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The global reduction in
MMR from 2000 to 2015 though impressive does not reflect the achievements of
individual countries, with those making little or no progress towards reducing
MMR of greatest concern. The reduction of an MMR which is already low can be
difficult but most countries with low rates in 2000 reduced their MMR further,
while 26 others with higher rates made little progress. While the WHO deems the
current data on MMR to be the most accurate to date care must be taken when
interpreting changes in MMR as just 50% of countries provide maternal mortality
data, which in many cases is incomplete. Nigeria, for example appears to have a
reduction in MMR from 2000 to 2015 however due to uncertainty in the data there
is a high possibility no progress has been made. Disparities within countries
can also be masked by the data e.g***marginalised groups. ????? those areas
where women most at risk not accounted for? With such disparities and questions
over the data it must be considered how much is not accounted for? The MMR
calculated for Sierra Leona for example, using new more accurate data showed
maternal mortality rates higher than previously estimated. Though it appears
maternal mortality is reducing at a global level we must be cautious in
interpreting the data available and be aware this may not reflect individual
country or within country levels. The fact that maternal mortality rates may be
much more than estimated must be considered.country or within country levels. The fact that maternal mortality rates may be
much more than estimated must be considered. 

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