Pakistan is ranked among four countries – together with Nigeria, India and Democratic Republic of the Congo (DRC) – that accounted for nearly half of the estimated 260,000 maternal deaths worldwide in 2023, according to UN data released Monday that has prompted stark warnings about the impact of cuts to aid funding by the US and the UK Maternal deaths include those related to complications during childbirth or pregnancy, three UN agencies said in a joint report. The Trends in maternal mortality report was published by the UN Children’s Fund (UNICEF), the World Health Organization (WHO) and UN sexual and reproductive health agency UNFPA, in observance of World Health Day on 7 April. The report showed that Nigeria had the highest number of maternal deaths and accounted for more than a quarter (28.7 percent) of all estimated global maternal deaths in 2023, with approximately 75,000 deaths. Only three other countries had more than 10,000 maternal deaths in 2023-India and DRC tied at 19,000, with Pakistan totaling 11,000. India and DRC accounted for 7.2 percent each, while Pakistan accounted for 4.1 percent of global maternal deaths. Together, these four countries accounted for almost half (47 percent) of all maternal deaths globally in 2023, according to the report. The report warned that unprecedented aid cuts are putting global progress to end maternal deaths at risk, and called for greater investment in midwives and other health workers. It shows that maternal deaths declined by 40 per cent between 2000 and 2023, largely due to improved access to essential health services. As aid funding cuts force countries to roll back vital services for maternal, newborn and child health, the UN agencies appeal for urgent action to prevent maternal deaths, particularly in humanitarian settings where numbers are already alarmingly high. “While this report shows glimmers of hope, the data also highlights how dangerous pregnancy still is in much of the world today – despite the fact that solutions exist to prevent and treat the complications that cause the vast majority of maternal deaths,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement. “In addition to ensuring access to quality maternity care, it will be critical to strengthen the underlying health and reproductive rights of women and girls – factors that underpin their prospects of healthy outcomes during pregnancy and beyond.” The report also provides the first global account of the COVID-19 pandemic’s impact on maternal survival. An estimated 40,000 more women died due to pregnancy or childbirth in 2021, rising to 282,000 in 2022, and to 322,000 the following year. This increase was linked not only to direct complications caused by COVID-19 but also widespread interruptions to maternity services, highlighting the importance of ensuring that this care is available during pandemics and other emergencies. “When a mother dies in pregnancy or childbirth, her baby’s life is also at risk. Too often, both are lost to causes we know how to prevent,” said UNICEF Executive Director Catherine Russell. With global funding cuts putting more mums-to-be at risk, especially in the most fragile settings, “the world must urgently invest in midwives, nurses, and community health workers to ensure every mother and baby has a chance to survive and thrive,” she added. The report also highlights persistent inequalities between regions and countries, as well as uneven progress. With maternal mortality declining by around 40 per cent between 2000 and 2023, sub-Saharan Africa achieved significant gains. It was also among just three UN regions to see significant drops after 2015, with the others being Australia and New Zealand, and Central and Southern Asia. Yet, sub-Saharan Africa still accounted for approximately 70 per cent of the global burden of maternal deaths in 2023 due to high rates of poverty and multiple conflicts. Meanwhile, five regions saw progress stagnate after 2015: Northern Africa and Western Asia, Eastern and South-Eastern Asia, Oceania (excluding Australia and New Zealand), Europe and North America, and Latin America and the Caribbean. Dr. Natalia Kanem, UNFPA’s Executive Director, upheld that access to quality maternal health services is a right, not a privilege. She stressed the urgent responsibility to build well-resourced health systems that safeguard the lives of pregnant women and newborns. “By boosting supply chains, the midwifery workforce, and the disaggregated data needed to pinpoint those most at risk, we can and must end the tragedy of preventable maternal deaths and their enormous toll on families and societies,” she said. The report also highlighted the plight of pregnant women living in humanitarian emergencies, who face some of the highest risks globally. Nearly two-thirds of global maternal deaths now occur in countries affected by fragility or conflict. Beyond ensuring critical services during pregnancy, childbirth and the postnatal period, the report emphasized the importance of efforts to enhance women’s overall health by improving access to family planning services, as well as preventing underlying health conditions that increase risks, such as anaemia, malaria and noncommunicable diseases. Furthermore, the report underscored the need for ensuring that girls stay in school, and that they and women have the knowledge and resources to protect their health.