Countries by Number of maternal deaths

Ranking 2023

Analysis

This metric counts the absolute number of maternal deaths in each country in a given year. A maternal death refers to the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. The unit is an absolute count, not a rate, meaning larger populations and higher birth volumes will tend to produce higher totals regardless of the quality of care. Data are drawn from the World Bank World Development Indicators, indicator code SH.MMR.DTHS, for the year 2023. Coverage spans 194 countries, all of which have data from the last seven years, and 100 percent of datapoints are classified as official. The ranking contains 20 extreme outliers at the 3-sigma threshold, reflecting the wide disparity across countries.

The top of the ranking is heavily concentrated in sub-Saharan Africa and South Asia. Nigeria alone accounts for 75,000 deaths, ranking first by a wide margin. Congo, Dem. Rep. and India share second place at 19,000 each, followed by Pakistan at 11,000 (rank 4) and Ethiopia at 8,000 (rank 5). Afghanistan (rank 6, 7,600), Tanzania (rank 7, 6,500), Indonesia (rank 8, 6,300), and Chad (rank 9, 6,100) round out the top ten. High absolute counts in this tier reflect a combination of large population size, high fertility rates, and the structure of data collection in each country, though the metric itself does not distinguish between these factors.

The middle of the ranking includes several large economies with notably lower totals. China ranks 34th with 1,400 deaths, and Brazil ranks 28th with 1,700. The United States ranks 49th with 610 deaths, placing it between Algeria (rank 51, 570) and Zambia (rank 50, 590) on the absolute count measure. India and the United States illustrate how absolute counts differ from rates: India's population and birth volume are vastly larger, driving a much higher total. Among smaller nations, Comoros (rank 92, 44) and Djibouti (rank 96, 39) appear in a tier alongside Canada (rank 94, 42) and Saudi Arabia (rank 95, 40), a grouping that reflects the absolute nature of the measure rather than comparable health system performance.

Because this metric uses absolute counts rather than rates, it systematically ranks countries with large populations and high birth volumes above smaller nations, regardless of the underlying risk per birth. Countries with poor civil registration systems may underreport deaths, meaning some totals could be undercounts. Conversely, improved registration in a given year could increase reported totals without reflecting a real worsening of outcomes. The 999 percent spread between the minimum value of zero and the maximum of 75,000 underscores how heavily population size shapes this ranking. The metric also excludes deaths from accidental or incidental causes unrelated to pregnancy, which requires cause-of-death attribution that may not be consistently applied across all reporting countries.

Methodology

Data are sourced from the World Bank World Development Indicators, indicator code SH.MMR.DTHS, for the reference year 2023. The metric counts absolute maternal deaths per country. A maternal death refers to the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. The ranking covers 194 countries, all of which meet the recency threshold with data from the last seven years. All 194 datapoints are classified as official quality. The dataset contains 20 extreme outliers at the 3-sigma threshold, driven by the wide absolute range from 0 to 75,000. Average year-over-year change across the dataset is 15.8 percent. Because absolute counts are used, population size and birth volume are major determinants of rank position, independent of maternal mortality rates.

Sources

• World Bank