Integrating family planning and maternity services reduces global maternal mortality – World Health Organization (WHO)

Report on Global Maternal Mortality Reduction and its Alignment with Sustainable Development Goals (SDGs)

Introduction

A landmark decomposition analysis published in The Lancet Global Health by the World Health Organisation (WHO) and the Human Reproduction Programme (HRP) provides critical evidence on the drivers of global maternal mortality reduction between 2000 and 2023. The study re-analysed data from 195 countries and territories, quantifying the distinct contributions of maternity care and family planning. The findings underscore the integrated approach required to achieve key Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality).

Key Findings from the Decomposition Analysis (2000-2023)

Overall Reduction in Maternal Mortality

• Global maternal mortality registered a significant decline of 41% between the years 2000 and 2023.

Attributable Factors to Mortality Decline

The analysis attributes the reduction in maternal deaths to two primary intervention areas:

1. Improvements in Maternity Care: Accounted for 61.2% of the decline.
2. Fertility Reduction and Contraceptive Use: Responsible for the remaining 38.8% of the decline.

Specific Impact of Contraceptive Use

• Increased contraceptive use was identified as a vital, life-saving intervention, independent of clinical maternity care.
• In 2023 alone, contraceptive use is estimated to have averted 77,400 maternal deaths. This figure represents nearly one-quarter of all maternal deaths averted that year.

Implications for Achieving Sustainable Development Goals

Progress Towards SDG 3: Good Health and Well-being

The study’s results directly inform strategies for achieving targets within SDG 3.

• Target 3.1: To achieve the goal of reducing the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030, the report indicates that an integrated approach combining family planning and maternity care is essential. This is particularly critical in low-income settings where contraceptive prevalence remains low.
• Target 3.7: The findings provide compelling evidence for ensuring universal access to sexual and reproductive health-care services. By quantifying the number of deaths averted through contraception, the study validates family planning as a core component of public health and a critical tool for achieving maternal survival goals.

Advancing SDG 5: Gender Equality

The report frames access to reproductive health services as fundamental to advancing gender equality.

• Access to contraception and quality maternity care are positioned not merely as health interventions but as foundational elements for saving lives and promoting gender equality.
• By enabling women to plan and space their pregnancies, these services support female empowerment, autonomy, and the prevention of complications from high-risk pregnancies and unsafe abortions.

Strategic Recommendations for Policy and Health Systems

Integrated Health Interventions

• Policy-makers and health systems must prioritize the effective integration of family planning services with maternity care to maximize impact on maternal mortality reduction.
• Efforts must focus on addressing the unmet need for family planning to ensure all women can plan their pregnancies safely.

Sustained Investment

• Continued and expanded investment in both family planning and maternal health is essential to save lives and accelerate global progress towards the 2030 SDG targets.
• The research offers a powerful message that this dual investment is a proven and effective strategy for improving maternal survival rates globally.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

   SDG 3: Good Health and Well-being

   • The article’s primary focus is on reducing maternal mortality, a core component of SDG 3. It explicitly mentions the “global decline in maternal deaths” and directly refers to “Sustainable Development Goal 3.1”. The entire study discussed is about improving health outcomes for mothers through maternity care and family planning.

   SDG 5: Gender Equality

   • The article links access to healthcare with women’s empowerment and rights. It quotes Pascale Allotey, who states that access to contraception and maternity care is “fundamental to saving lives and advancing gender equality.” The article also frames access to contraception as a matter of “human rights, choice and empowerment” for women.

2. What specific targets under those SDGs can be identified based on the article’s content?

   SDG 3: Good Health and Well-being

   • Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births. The article explicitly mentions this target: “…achieving the Sustainable Development Goal 3.1 target, to reduce the global maternal mortality ratio to fewer than 70 deaths per 100 000 live births by 2030…”
   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education. The article strongly supports this target by highlighting that “38.8% [of the decline in maternal mortality] stems from fertility reduction” and that “increased contraceptive use alone averted an estimated 77 400 maternal deaths in 2023.” It calls for expanded investments in “sexual and reproductive health.”

   SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights. The article advocates for this target by emphasizing that contraception is a “matter of human rights, choice and empowerment.” It also stresses the need to “ensure that women can plan their pregnancies safely” and that “every woman, everywhere, has the means to plan her family.”

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

   Indicators for SDG 3

   • Indicator 3.1.1 (Maternal mortality ratio): The article is centered on this indicator. It quantifies past progress, stating that “global maternity mortality declined by 41% between 2000 and 2023,” and it cites the specific 2030 target of reducing the ratio to “fewer than 70 deaths per 100 000 live births.”
   • Indicator 3.7.1 (Proportion of women of reproductive age who have their need for family planning satisfied with modern methods): This indicator is strongly implied. The article discusses the impact of “increased contraceptive use,” the need to address “unmet need for family planning,” and the problem of low “contraceptive prevalence” in certain regions. The statistic that contraception averted 77,400 deaths is a direct outcome of this indicator’s progress.

   Indicators for SDG 5

   • Indicator 5.6.1 (Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care): The article implies this indicator through its repeated emphasis on “choice and empowerment.” The statement that we must “ensure that every woman, everywhere, has the means to plan her family” directly relates to a woman’s ability to make her own decisions about reproductive health.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article. In this table, list the Sustainable Development Goals (SDGs), their corresponding targets, and the specific indicators identified in the article.

   SDGs	Targets	Indicators
   SDG 3: Good Health and Well-being	Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.	Indicator 3.1.1 (Maternal mortality ratio): Mentioned directly as the “global maternal mortality ratio” with a target of “fewer than 70 deaths per 100 000 live births.”
   SDG 3: Good Health and Well-being	Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning.	Indicator 3.7.1 (Need for family planning satisfied): Implied through discussion of “increased contraceptive use,” “unmet need for family planning,” and low “contraceptive prevalence.”
   SDG 5: Gender Equality	Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights.	Indicator 5.6.1 (Women making their own informed decisions): Implied through the framing of contraception as a matter of “human rights, choice and empowerment” and ensuring women can “plan their pregnancies safely.”

Source: who.int