The right to count

This case report, published in the Lancet, examines the issue of under-reporting of maternal deaths in developing countries, and considers the implications for the UN Millennium Goal target of reduction maternal mortality by three-quarters by 2015. It reports that, even in several developed countries, under-reporting of maternal deaths ranges from 17 per cent to 63 per cent. But in the world’s poorest countries, vital registration and health services data are totally lacking or highly unrepresentative of particular subgroups, especially the poorest. Barriers to setting up and maintaining national health information systems have included financial constraints, skills shortages, and politics.

The authors conclude by drawing attention to the perversity of promoting maternal mortality reduction as a goal without addressing the weaknesses of information systems to monitor progress. They argue that to deny women and their families the right for their health burden to be counted is to ignore the burden itself. It thus presents fundamental challenges to the poverty reduction strategies of developing countries.

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