Inequalities in geographical access to emergency obstetric and newborn care.

In 2020, an estimated 287 000 women died due to complications of pregnancy and childbirth, while 1.9 million still-births occurred in 2021. As many as half of maternal deaths and three in four stillbirths are preventable if women can access timely emergency care that is provided by skilled health personnel.(1) To date, efforts of the global community to reduce maternal mortality and stillbirths have mostly focused on ensuring the availability of emergency obstetric and newborn care, minimizing financial barriers to care and, more recently, improving care quality. However, governments have given less attention to geographical accessibility and inequalities in access between and within populations. Pregnant women in low- and middle-income countries often need to seek care on their own, even in emergencies, and many face immense challenges in reaching emergency obstetric and newborn care facilities.(2) Here we examine the geographical accessibility to emergency obstetric and newborn care in low- and middle-income settings. We argue for the use of emerging scientific evidence and contextual understanding to better identify priority problem areas, select appropriate methods, and develop solutions and targets related to assessing geographical accessibility for emergency obstetric and newborn care.