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The apparent failure to reduce maternal mortality during 20 years of the Safe Motherhood movement has been one of the most deforming scars on the body of global health. Despite strong advocacy efforts, political leaders have either ignored the call or failed to make the health of women in pregnancy their priority. This striking lack of progress, despite maternal mortality reduction being awarded its own Millennium Development Goal (MDG-5) in 2000, has been a source of puzzlement and embarrassment to global health leaders. A sense of failure has triggered deeply reflective analyses to isolate its causes.

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