Improvement of maternal health is one of the eight Millennium Development Goals adopted by the Member Countries of the United Nations in 2000. This is a clear indication of the importance afforded to maternal health as well as its role in the eradication of poverty. In particular, the lessening of maternal mortality, provision of skilled care during childbirth, access to antenatal care and strategies to increase contraceptive uptake were highlighted.
Data published by the World Health Organization (2012) indicated that maternal mortality (MMR) for the Caribbean decreased from 280 maternal deaths per 100 000 live births in 1990 to 190 deaths in 2010. This represents an overall decrease of 30% in mortality over the 20-year period. This decrease falls short of the target necessary to achieve the fifth Millennium Development Goal. The targets for the latter include a 75% reduction in maternal mortality as well as universal access to reproductive health by the year 2015.
It should be noted that several Caribbean countries were categorized as having a low MMR (<100) in 1990: Bahamas, Grenada, Jamaica, St. Lucia, St. Vincent & the Grenadines, Suriname, and Trinidad & Tobago. These countries, with the exception of Suriname and Jamaica, experienced a further decline in MMR by 2010. Also, Guyana and Barbados were classified as having moderate MMRs (100-299) in 1990. Barbados experienced a decrease and was considered to be “making progress” by 2010. However, Guyana’s MMR increased from 180 in 1990 to 280 (estimated) in 2010. Haiti was the only Caribbean country with a high MMR (≥300) in 1990. By 2010, Haiti was also classified as “making progress” over the 20 year period with annual declines as high as 5%.
There were few published reports of research studies conducted to determine the causes of maternal mortality for the Caribbean. McCaw-Binns and Lewis-Bell (2009) found that for the period 2001-2003, the leading causes of maternal mortality for Jamaica were gestational hypertension, thromboembolism, haemorrhage, HIV, abortions, cardiac disorders, sickle cell disease, obstetric trauma, ectopic pregnancy and diabetes mellitus. They identified the development of clinical guidelines to facilitate standardized management of the common complications as well as the implementation of maternal mortality surveillance systems as being vital to the lowering of mortality rates.
It is believed that approximately 95% of maternal mortality in the Caribbean can be prevented. More so, health care solutions to prevent and manage complications are available. Access to antenatal care in pregnancy, skilled care during childbirth and care and support in the weeks afterwards are all important aspects of maternal care. The prevention of unwanted and unplanned pregnancies were also identified as key factors to be considered as we work together to decrease maternal mortality in the Region.