# Impact of health intervention coverage on reducing maternal mortality in 126 low- and middle-income countries: a Lives Saved Tool modelling study

## TL;DR

This study models how increasing health intervention coverage in 126 low- and middle-income countries could reduce maternal deaths but finds it unlikely to meet global targets by 2030.

## Contribution

The novel contribution is modeling the impact of different intervention coverage scenarios on maternal mortality in LMICs using the Lives Saved Tool.

## Key findings

- Even with substantial or universal coverage, MMR in 126 LMICs is unlikely to meet SDG Target 3.1 by 2030.
- Uterotonics, assisted vaginal delivery, and cesarean delivery are most effective in reducing maternal mortality.
- Maternal lives saved are concentrated in Africa, Southeast Asia, and the Eastern Mediterranean.

## Abstract

There is a continued and urgent need to address the stagnation of the global maternal mortality ratio (MMR), especially for low- and middle-income countries (LMICs). We aimed to assess the impact of scaling up health intervention coverage on reducing MMR under four scenarios for 126 LMICs.

We conducted the modelling study to estimate MMR and additional maternal lives saved by intervention by 2030 for 126 LMICs using the Lives Saved Tool (LiST). We applied four scenarios to assess the impact of scaling up health intervention coverage with no scale-up (no change), a modest scale-up (increased by 2% per year), a substantial scale-up (increased by 5% per year), and universal coverage (coverage reached 95% by 2030). In sensitivity analysis, with the current trend, we assumed that coverage of each intervention remained unchanged from 2024, with MMR changing according to the annual percentage change (APC) of 2015–2020.

Among the 126 LMICs, 31.7% (40/126) countries showed an increase in MMR, and 38.1% (48/126) stalled on the reduction of MMR from 2015 to 2020. With a modest, substantial, or universal scale-up, the 2030 average MMR would be 172.1 (117.6–262.9), 139.8 (95.6–213.5) or 98.6 (67.8–149.7), not reaching the SDG Target 3.1. Additional maternal lives saved by scaling up the coverage of health interventions were mainly clustered in the African Region, the Southeast Asia Region, and the Eastern Mediterranean Region. Compared with other included interventions, uterotonics for postpartum hemorrhage, assisted vaginal delivery and cesarean delivery played more important roles in reducing maternal mortality.

The study findings highlighted that even under a substantial scale-up of intervention coverage or scaling up to universal coverage of interventions, it would be difficult for the 126 LMICs to achieve the SDG Target 3.1 on time. Optimizing the allocation of health resources, promoting health equality, taking more decisive national, regional and global actions are urgently needed for LMICs to reduce MMR and reach the SDG Target 3.1.

The online version contains supplementary material available at 10.1186/s41256-025-00414-0.