Governance commitment to reduce maternal mortality. A political determinant beyond the wealth of the countries

Some countries reached, in 2015, the Millennium Development Goal of reducing maternal mortality to 96 or less maternal deaths per 100,000 live births. Others, however, did not. This paper analyses the strength of the association between maternal mortality and each of the six components of Governance—a political determinant scarcely explored in the literature—in 174 countries. It was found that the greater the governance, the lower maternal mortality, independently of a country's wealth. We used all six indicators of the World Bank's Worldwide Governance Indicators Project in 2015: government effectiveness, regulatory quality, rule of law, control of corruption, voice and accountability, and political stability and absence of violence. Findings were encouraging as maternal mortality in low-income countries with higher government effectiveness and regulatory quality was similar to that of medium-income countries with lower government effectiveness and regulatory quality. To achieve the post-2015 sustainable development goal on preventable maternal mortality—which persists despite economic development—all governance dimensions are essential and represent interdependent cornerstones. •Maternal mortality is associated with the six World Bank's Governance Indicators.•Adjusting by wealth, the lower the governance level, the higher the maternal mortality.•Government effectiveness is as important for maternal mortality reduction as wealth.•Similarly, regulatory quality is as important as wealth for maternal mortality.•It shows the understudied link between voice and accountability, and maternal mortality.