As global ministers gather today in Ethiopia to discuss how efforts to improve maternal health can be ramped up, Merlin is calling for urgent investment in midwives in crisis countries.

Of all the global pledges to reduce poverty, Millennium Development Goal 5 - to cut maternal death by 75 per cent by 2015 - is the most off track. Yet while progress is painfully slow in the majority of countries, in crisis countries like Afghanistan and Sudan more women are dying in pregnancy and childbirth than ever before.

Maternal health efforts failing in crisis countries
In the Central African Republic, a mother runs nearly twice the risk of dying in childbirth today than in 1988. In conflict-affected DR Congo, figures show an increase of 11.1 per cent in the ratio of women dying between 2000 and 2005.

Yet three quarters of these mothers could be saved if only they had access to a midwife.

In the UK almost all births are attended by a health worker, while in Ethiopia - seat of this high level event - less than six per cent of deliveries are assisted.

Training local health workers = meeting global targets

Linda Doull, our Director of Health and Policy at Merlin, is clear about what needs to be done:

'Crisis countries can no longer be sidelined simply because they're challenging.
These countries carry the greatest burden of death and disease yet have the fewest skilled health workers. We must channel aid into training health workers in the countries where most women and children die to have any real impact on global health.'

In 2007, crisis countries received just 38.4 per cent of Overseas Development Aid, despite accounting for a third of all maternal deaths and 50 per cent of child mortality.

Dr Tewodros GebreMichael, our Country Health Director in Ethiopia, says:

'As maternal mortality increases in fragile states, the number of midwives graduating and working in Ethiopia is going down. No woman should have to die giving life. We need more health workers to allow women in Ethiopia's remote communities one of the most basic health rights - access to a midwife who can provide life-saving care.'

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Hear about Merlin's maternal health work in CAR on BBC World Service