Maternal mortality continues to be a major health problem worldwide with unacceptably high numbers of preventable cases (303 000 maternal deaths reported in 2015). Risks during pregnancy vary among communities, countries, and regions. The risks are 15 times higher in low‐income than in high‐income countries due to poor resources and weak dysfunctional health services; as a result, the maternal mortality ratio (MMR), a health indicator of development and quality of life, shows the largest disparities between wealthy and impoverished countries. In this context and with the aim of exploring this issue in Lebanon, a group of researchers form the Faculty of Health Sciences (FHS) led by Dr. Faysal El-Kak and Tamar Kabakian, and colleagues from the of Faculty of Medicine (FM) and the Ministry of Public Health in Lebanon conducted the first paper on maternal mortality trends in Lebanon in 2010-2018.
Lebanon invested in the prevention of maternal mortality after the civil war, which left a deficient vital registration system leading to unreliable estimates of maternal mortality ratio (MMR). Starting in 2004, the Ministry of Public Health integrated reproductive health into primary health care and established a national notification system of maternal and neonatal deaths. From 1990 to 2013, Lebanon achieved an annual change in MMR of -7.5%, which was the highest rate of reduction in the region and met the requirements of Millennium Development Goal 5. For the period 2010-2018, data collected through the national notification system indicate an MMR of 14.9, which is below the officially reported MMR of 23.
Since the influx of Syrian refugees, Lebanon has experienced a rise in the number of live births with a slightly increasing trend in MMR, especially in regions with the highest concentration of refugees. Causes of maternal mortality in Lebanon align with the three-delays model, pointing to deficiencies in the quality of maternity care. The research found that more efforts are needed toward strengthening the national notification system to include cases that occur outside hospitals, identifying near-miss cases, reinforcing the emergency response system, and engaging with all stakeholders to improve quality of care.