Maternal Health Services and Quality of Care

Maternal health services encompass antenatal care, skilled birth attendance, emergency obstetric care and postnatal follow-up, all of which aim to safeguard the health of pregnant and postpartum women. Quality of care is measured by timeliness, safety, effectiveness and respectful treatment. Despite global progress, inequities persist within and between countries, with sub-Saharan Africa and south Asia bearing the highest burden of maternal death and stillbirth. Critical components include early detection of complications, staffed facilities, reliable supply chains and robust data systems. Health-system strengthening must address both access and the standard of service delivery, integrating socio-economic, cultural and infrastructural determinants to reduce preventable morbidity and mortality.

Research from Nature Portfolio

Recent studies have employed advanced computational and statistical methods to deepen understanding of maternal health trajectories. One investigation developed a global microsimulation model that synthesises demographic, clinical and health-system data for 200 countries to estimate maternal mortality by cause from 1990 through 2050. Projections indicate that while maternal deaths have declined by over 40% since 1990, current trends may fall short of Sustainable Development Goal targets without context-specific policy interventions. Another study introduced a small area statistical model for estimating local and temporal patterns of healthcare quality using health-facility survey data. Applied to multiple countries, this geospatial approach revealed substantial subnational disparities in readiness to deliver essential services and demonstrated strong predictive validity, offering a tool for decision-makers to target quality improvements at programme level.

Maternal Health Services and Quality of Care publication trend

The graph below shows the total number of articles in maternal health services and quality of care across all publications each year (not limited to Nature Index journals).

Technical terms

Maternal mortality ratio: Number of maternal deaths per 100,000 live births, reflecting risk associated with pregnancy.

Microsimulation model: Computational framework that simulates individual life events and clinical pathways to project population-level health outcomes.

Small area statistical model: Geospatial analytical method that estimates health indicators at subnational or local levels using spatial and temporal correlations.

Stillbirth rate: Number of fetal deaths at a specified gestational age per 1,000 total births, used to assess perinatal health services.

Service Availability and Readiness Assessment (SARA): WHO framework for evaluating health facility capacity to provide essential services, including infrastructure, equipment and personnel.

References

1. Simulation-based estimates and projections of global, regional and country-level maternal mortality by cause, 1990–2050. Nature Medicine (2023).
2. A small area model to assess temporal trends and sub-national disparities in healthcare quality. Nature Communications (2023).
3. Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021. The Lancet (2024).
4. A global analysis of the determinants of maternal health and transitions in maternal mortality. The Lancet Global Health (2023).