Determinants of cross-country variation in maternal mortality in developing countries

Abdul-Aziz M. Farah, Independent Consultant
Haider Rasheed, United Nations Population Fund (UNFPA)

The central concern of this paper is to discuss evidence on the determinants of maternal mortality changes in developing countries. It presents an assessment of the relative roles in mortality changes of economic growth versus health services and women’s empowerment strategies. This assessment typically uses bivariate and multivariate analyses directed at explaining maternal mortality variation across 99 developing countries by means of dominant determining factors. Three crucial messages have emerged. First, per-capita income becomes a weak predictor of cross-country maternal mortality variance when non-economic variables are taken into account. Evidently, income growth is not a sufficient condition for poor countries to reduce maternal mortality. Second, public health measures actively work to bring about substantial maternal health gains, even when economic growth was stagnant. Third, the women’s empowerment significantly predicts the inter-country variation in maternal mortality, and thus plays a substantial role in maternal mortality transition. To conclude, poor countries can circumvent poverty barriers and realize additional maternal health gains if women’s status, including their political rights, education and other forms of empowerment, was promoted and if the health-sector was tailored to national safe-motherhood priorities.