Maternal reproductive health-one of the most neglected global public-health catastrophes-is the theme for the first issue of THE LANCET in 2004. A mini-series highlighting the key global challenges for maternal health, a research article and the journal's editorial join forces to help put the unnecessary pregnancy-related complications and deaths of half a million mothers-99% in developing countries-higher up the global public-health agenda.

The series highlights the five major direct causes of maternal deaths worldwide: haemorrhage (25% of maternal deaths), sepsis (15%), abortion complications (13%), eclampsia (12%), and obstructed labour (8%). Many of these causes can be addressed by investing in effective technologies and ensuring their availability to all women in need.

Adrienne Germain introduces the series (1) and comments: "2004 marks the 10th anniversary of ICPD [International Conference on Population and Development], when the world's nations recognised reproductive health and rights, women's empowerment, and gender equality as important global goals. We hope that this series of articles highlights some of the challenges that remain, and serves as a reminder that these issues underlie many of the world's most pressing problems."

Wendy Graham and JuliA Hussein (2) outline how monitoring progress towards the Millennium Development Goals of reducing maternal mortality by three-quarters by 2015 is seriously challenged by weak health information systems. They comment how many maternal deaths today remain as silent tragedies. Wendy Graham is also the lead author of a research article (p 23) in this week's issue which highlights how maternal death is closely associated with poverty; authors of the study demonstrate how their methodology makes efficient use of existing survey data and could be used to explore the rich-poor gap in other health outcomes, such as adult mortality.

Peru's recent experience (3) is discussed by Jaime
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
1-Jan-2004

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