The 2023 estimates of the maternal mortality ratio (MMR) in the Region from the United Nations Maternal Mortality Estimation Group drew from data from the period 2000–2020. Worldwide, the annual percentage reduction in maternal deaths between 2000 and 2020 was 34.3%. However, the annual percentage reduction in maternal deaths in the Region barely reached 2.8%. 

The 2025 target for MMR is 35 deaths per 100 000 live births (informed by the SHAA2030 target of 30), but the regional rate in 2020 was 65.8 deaths per 100 000 live births, higher than the 2015 baseline of 58.0. For the Region to achieve the target by 2025, it is necessary to reduce MMR annually at an average rate of 5%. However, from 2015 (baseline year) to 2020 (the last year with available information), MMR increased annually at an average rate of 2.5%. 

The largest excess of maternal deaths was recorded in 2020, due to the COVID-19 pandemic and its impact on health services, which included interruption in antenatal care and reduced access to qualified childbirth care, among other challenges. Nonetheless, insufficient prioritization of maternal health in the health agendas of some Member States and a lack of criteria for focusing actions on population groups in greater conditions of vulnerability had already led to a worsening trend before 2020. 

The impact of COVID-19, combined with lack of progress between 2015 and 2020, has resulted in maternal mortality rates not seen in the Region since 2002. COVID-19 has highlighted the vulnerabilities in health infrastructure and exacerbated disparities in accessing healthcare. Progress in reducing maternal mortality in the Region over the past two decades has actually reversed, due to the pandemic. The slowdown in reducing preventable maternal deaths has disproportionately affected vulnerable populations, worsening health inequalities and jeopardizing Member States' collective goals. 

Recommendations 

• Prioritize the maternal health agenda as a key component of health system strengthening. Focus efforts on preventing avoidable maternal deaths among vulnerable groups. 

• Harness national and subnational data to identify and target areas lacking quality service delivery and coverage during periods of prenatal, delivery, and postnatal/postpartum care. PASB has developed a methodology that has effectively addressed this recommendation. 

• Iteratively update national procedures in accordance with the evolving recommendations of PAHO’s Strategic Advisory Groups focused on reducing maternal mortality.