Maternal mortality has been reduced by half from 1990 to 2010, yet a woman in sub-Saharan Africa has a lifetime risk of maternal death of 1 in 39 compared with around 1 in 10,000 in industrialized countries. Annual rates of reduction of maternal mortality of over 10% have been achieved in several countries. Highly cost-effective interventions exist and are being scaled up, such as family planning, emergency obstetric and newborn care, quality service delivery, midwifery, maternal death surveillance and response, and girls' education; however, coverage still remains low. Maternal mortality reduction is now high on the global agenda. We examined scenarios of reduction of maternal mortality by 2035. Ending preventable maternal deaths could be achieved in nearly all countries by 2035 with challenging yet realistic efforts: (1) massive scaling-up and skilling up of human resources for family planning and maternal health; (2) reaching every village in every district and every urban slum toward universal health coverage; (3) enhanced financing; (4) knowledge for action: enhanced monitoring, accountability, evaluation, and R&D.
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