A number of initiatives that commenced in recent years are geared towards achievement
of the fifth Millennium Development Goal (MDG 5: Improving maternal health), most
notably the launch of the Global Strategy for Women’s and Children’s Health in 2010 by
the United Nations (UN) Secretary-General. Subsequently, the high-level Commission
on Information and Accountability for Women’s and Children’s Health was established
to “determine the most effective international institutional arrangements for global
reporting, oversight and accountability on women’s and children’s health.” One of the ten
recommendations of the commission was specific to improving measurement of maternal
(and child) deaths. This recommendation requires that “by 2015, all countries have taken
significant steps to establish a system for registration of births, deaths and causes of death,
and have well-functioning health information systems that combine data from facilities,
administrative sources and surveys”. The first report of the independent Expert Review Group
(iERG) established by the commission for overseeing the progress in achievement of the
commission’s 10 recommendations indicated insufficient progress in the implementation of
the recommendations including the one on ‘vital events’ reporting.
Measuring the MDG 5 target of reducing the maternal mortality ratio (MMR) (target 5A)
remains a challenge. Less than 40% of countries have a complete civil registration system
with good attribution of cause of death, which is necessary for the accurate measurement of
maternal mortality.
The estimates for 2013 presented in this report are the seventh in a series of analyses by the
United Nations agencies. The Maternal Mortality Estimation Inter-Agency Group (MMEIG),
comprising the World Health Organization (WHO), the United Nations Children’s Fund
(UNICEF), the United Nations Population Fund (UNFPA), the United Nations Population
Division (UNPD) and The World Bank, together with a team at the National University of
Singapore, Singapore and University of California at Berkeley, United States of America,
have been working together to generate internationally comparable MMR estimates. A
technical advisory group (TAG) provides independent technical advice. The methods, as well
as the data sources for the estimation of MMR, have improved over time. Building on the
methodological advancements from the previous round of analyses, newly available data
collected by MMEIG and obtained during country consultation were incorporated, and trend
estimates from 1990 to 2013 were generated. As with the previous round of estimates, the
statistical code and input data necessary to produce the current estimates are made publicly
available, underscoring the MMEIG’s commitment to open access and transparency.