Less than three years remain until the 2015 deadline to achieve the United Nation's Millennium Development Goals (MDGs). Over the last two decades, slow but sustained progress has been made in improving maternal health (MDG 5) in Iraq.
The maternal mortality ratio fell by 29% from 89 in 1990 to 63 in 2010. The proportion of deliveries attended by skilled health personnel rose considerably from 50% in 1990 to 88.5% in 2011 and institutional deliveries increased from 62% in 2006 to 75% in 2011. However, this progress will still not be enough for Iraq to meet the planned MDG 5 target of reducing the maternal mortality ratio by 75% in 2015.
The effects of war, internal conflict and sanctions have contributed to the slow pace of decline in maternal mortality, placing Iraq in the group of 68 countries that account for 97% of all maternal and child deaths globally according to Trends in maternal mortality: 1990 to 2010: WHO, UNICEF, UNFPA and The World Bank estimates.
A Ministry of Health maternal deaths' study in 2009 found that the leading direct causes of pregnancy-related deaths in Iraq are haemorrhage (33%), thromboembolism (25%), pre-eclampsia/eclampsia (9%), maternal sepsis (5%) and obstructed labour (4%).
One in four delivering women in Iraq faces serious complications during pregnancy and child birth. The government of Iraq has shown a high level of commitment to accelerating the implementation of a cost-effective and evidence-based package of interventions along the continuum of care in full collaboration with partners.
The Ministry of Health, with the technical support of UNFPA, UNICEF, WHO and other partners, has started working to improve the accessibility and provision of high quality health services to children and mothers as a key strategy for addressing the maternal mortality ratio, including the timely provision of essential medicines and commodities.
In addition, the implementation of Integrated Management of Childhood Illness (IMCI), which encompasses the key cost-effective interventions at both health facility and community levels, focusing on the most needy populations in remote rural areas and addressing inequities, has been expanded by more than 50% in 16 governorates from 2011 to 2012.
Concerted efforts and innovation are still needed to prevent maternal deaths, in order to save a greater number of mothers' lives, accelerate the pace of reduction of maternal mortality and bring the country closer to the MDG target. This could be achieved through the allocation of the required human and financial resources, by strengthening the recording and reporting system, developing a national plan to which all partners contribute, establishing a strong monitoring system to measure progress and fostering co-ordination between the public and private sectors.