Maternal Mortality in the Islamic Republic of Iran: On Track and in Transition

The Maternal Mortality Ratio is an important public health indicator that reflects both the quality of a health care system
and the role of women within that society. In September 2000 the United Nations Millennium Declaration outlined the eight
Millennium Development Goals (MDGs) that set targets to be achieved by 2015. MDG 5 focused on improving maternal health. It
had two clear subgoals: to reduce maternal mortality globally by three quarters between 1990 and 2015 and to obtain universal
access to reproductive health for women. Despite a global trend of declining maternal mortality only a handful of nations
are currently ‘on track’ to achieve their MDG targets by 2015. The Islamic Republic of Iran is one of these nations. In just
over three decades, Iran has undergone demographic transition with significant reductions in total fertility and population
growth rates. In concert with this transition, Iran has achieved a dramatic decline in the maternal mortality ratio that has
fallen to a rate comparable with developed nations. Significantly Iran has also experienced a paradigm shift in its major
causes of maternal mortality from those characteristic of developing nations (postpartum haemorrhage, infection) to causes
more commonly seen in developed nations (pulmonary embolus, stroke). There is no single explanation that may account for this
transition, rather it is the product of a number of different initiatives that have incorporated family planning, grass roots
focus and wider improvements within the health care system of Iran over the past three decades. However the experience of
this nation may provide a useful example to other developing countries looking to reduce maternal mortality.