Maternal mortality remains one of the major challenges in global health and an important marker of social inequalities and unequal access to health services.

According to estimates from the World Health Organization (WHO et al., 2023), around 287,000 women died from causes related to pregnancy and childbirth in 2020, equivalent to one maternal death every two minutes. The global maternal mortality ratio was estimated at 223 maternal deaths per 100,000 live births.

Inequalities between world regions remain striking. In 2020, sub-Saharan Africa presented a maternal mortality ratio of 545 maternal deaths per 100,000 live births, while Latin America and the Caribbean recorded a ratio of 88 maternal deaths per 100,000 live births. The report also highlights concerns regarding stagnation and, in some contexts, worsening indicators. Between 2016 and 2020, Latin America and the Caribbean experienced an estimated 14.8% increase in maternal mortality  (WHO et al., 2023).

The highest maternal mortality ratios in 2020 were observed in South Sudan (1,223 maternal deaths per 100,000 live births), Chad (1,063), and Nigeria (1,047). Nigeria alone accounted for approximately 28.5% of all global maternal deaths during the period  (WHO et al., 2023).

Research conducted by investigators from the International Center for Equity in Health (ICEH) has contributed to a better understanding of inequalities in maternal health across different social and geographic contexts. Studies carried out in low- and middle-income countries show that poorer women, those with lower levels of education, and those living in rural areas experience reduced access to adequate antenatal care, skilled birth attendance, and essential obstetric services.

Analyses conducted in cities across sub-Saharan Africa identified differences of up to 13.5 percentage points in the coverage of four or more antenatal care visits between poor and non-poor women (Blumenberg et al., 2023).

Other studies show that countries affected by conflict experience persistently higher levels of maternal mortality and greater inequalities in access to reproductive and maternal health services (Akseer et al., 2020).

Evidence also indicates that increasing service coverage alone is not sufficient. Recent studies demonstrate that many countries still face major challenges related to the quality of antenatal and obstetric care, especially among socially vulnerable populations (Arroyave et al., 2021; Blanchard et al., 2026).

In Brazil, today marks the National Day for the Reduction of Maternal Mortality, and ICEH reaffirms the importance of producing scientific evidence, monitoring health inequalities, and strengthening public policies guided by health equity, so that no woman is left behind.