Maternal mortality in Sierra Leone: from civil war to Ebola and the sustainable development goals

More than 1 year has passed since Sierra Leone marked the end of the largest Ebola virus epidemic ever recorded. However, maternal mortality remains a major challenge. The country’s maternal mortality ratio (MMR) is the highest in the world, estimated by the UN Maternal Mortality Estimation Inter-Agency Group to be 1360 [80% uncertainty interval (UI), 999–1980] deaths per 100,000 live births (WHO et al. 2015). This is higher than what the Demographic and Health Survey reports (1165 per 100,000 live births), given incomplete civil registration and vital statistics (CRVS) (Statistics Sierra Leone and ICF International 2014). In contrast, the Millennium Development Goal (MDG) 5A target the country needed to achieve by 2015 was 450 maternal deaths per 100,000 live births