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1 In Maternal mortality : 1990 to 2015 estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division Trends in maternal mortality : 1990 to 2015 estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population DivisioniiWHO Library Cataloguing-in-Publication DataTrends in maternal mortality : 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population mortality Trends . Welfare. Collection methods. , Statistical. Health Organization. Bank.

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5 IiiContentsAcknowledgments ..viAcronyms and abbreviations ..viiiExecutive summary ..x1 Introduction ..12 Methodology for the 1990 2015 estimates of maternal mortality ..32 .1 Methodological refinements ..32 .2 Model input variables ..42 .3 Country data on maternal mortality used for the 1990 2015 estimates ..52 .4 Statistical modelling ..112 .5 Maternal mortality indicators estimated by the model ..122 .6 Uncertainty assessment ..132 .7 Model validation ..143 Analysis and interpretation of the 2015 estimates .

6 153 .1 Maternal mortality estimates for 2015 ..163 .2 Trends in maternal mortality from 1990 to 2015 ..203 .3 Comparison with previous maternal mortality estimates ..224 Assessing progress and setting a trajectory towards ending preventable maternal mortality ..234 .1 Millennium Development Goal 5 outcomes ..234 .2 Looking towards the future ..244 .3 A call to action ..28 References ..29 Annexes ..33 Suggested citation: Trends in maternal mortality : 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division.

7 Geneva: World Health Organization; , UNICEF, UNFPA, World Bank Group and UNPD estimatesList of tablesTable 2 .1 . Availability of maternal mortality data records by source type and country for use in generating maternal mortality ratio estimates (MMR, maternal deaths per 100 000 live births) for 2015 .. 6 Table 3 .1 . estimates of maternal mortality ratio (MMR, maternal deaths per 100 000 live births), number of maternal deaths, and lifetime risk, by United Nations Millennium Development Goal (MDG) region, 2015 .. 17 Table 3.

8 2 . estimates of maternal mortality ratio (MMR, maternal deaths per 100 000 live births), number of maternal deaths and AIDS-related indirect maternal deaths, by United Nations Millennium Development Goal (MDG) region, 2015 .. 18 Table 3 .3 . Comparison of maternal mortality ratio (MMR, maternal deaths per 100 000 live births) and number of maternal deaths, by United Nations Millennium Development Goal (MDG) region, 1990 and 2015 .. 21vTrends in maternal mortality 1990 to 2015 List of annexesAnnex 1 . Summary of the country consultations 2015.

9 33 Annex 2 . Measuring maternal mortality .. 34 Annex 3 . Methods used to derive a complete series of annual estimates for each covariate, 1985 2015 .. 41 Annex 4 . Adjustment factor to account for misclassification of maternal deaths in civil registration and vital statistics, literature review of specialized studies .. 42 Annex 5 . Usability assessment of vital registration data for selected years (1990, 1995, 2000, 2005, 2010 and latest available year) .. 45 Annex 6 . Estimation of AIDS-related indirect maternal deaths.

10 49 Annex 7 . estimates of maternal mortality ratio (MMR, maternal deaths per 100 000 live births), number of maternal deaths, lifetime risk, percentage of AIDS-related indirect maternal deaths and proportion of deaths among women of reproductive age that are due to maternal causes (PM), by country, 2015 .. 51 Annex 8 . estimates of maternal mortality ratio (MMR, maternal deaths per 100 000 live births), number of maternal deaths, and lifetime risk, by WHO region, 2015 .. 58 Annex 9 . Trends in estimates of maternal mortality ratio (MMR, maternal deaths per 100 000 live births), by WHO region, 1990 2015.