Objectives: To measure the institutional maternal mortality ratio (MMR) in Mali and suggest ways to reduce it.
Methods: Routinely recorded data from 24 health institutions in three regions were reviewed for 1988 to 1992.
Results: The overall MMR in the institutions was 201 maternal deaths per 100,000 live births. Hemorrhage, toxemia and infections accounted for 80% of the 360 recorded maternal deaths, almost all of which were preventable. The main reasons why these conditions result in death lie in poor quality and maldistribution of health services, lack of transport and late use of allopathic services.
Conclusions: Maternal mortality is still a major public health problem in Mali, even among the small proportion of women who reach health facilities. Substantial new initiatives are urgently needed to reduce this major cause of preventable adult female mortality.