Blood-Pressure Gap in Antenatal Care Across 72 Countries

Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review

Quick Answer: What is the blood-pressure gap in antenatal care?

The blood-pressure gap in antenatal care is the percentage of women who received antenatal care for their most recent birth and did not have their blood pressure measured during that care. Across 48 countries with surveys from 2015 to 2025, the median gap is 4.3% (interquartile range 1.9% to 10.3%).

Every number in this article was calculated in code, recalculated independently by a second AI system and read by a physician. Last check: 11 November 2026.

What the research says

• Hypertensive disorders caused 16% of global maternal deaths between 2009 and 2020. Across global maternal mortality estimates, hypertensive disorders (80% uncertainty interval 14% to 19%) ranked third among causes of maternal death, following haemorrhage (27%) and indirect obstetric deaths (23%) (Cresswell et al., Lancet Glob Health, 2025).

• Blood pressure measurement was the most frequently offered of six antenatal care components across 31 sub-Saharan African countries, though overall good-quality care remained low. In national survey data covering 204,776 women with antenatal care visits, 88.1% had their blood pressure measured, while 15.0% received good-quality antenatal care as defined from all six components (Getnet et al., BMJ Open, 2025).

• In nine East African countries, 54.4% of women had four or more antenatal contacts, but 21% received all six recommended services. Among 87,068 women surveyed, coverage of both favoured richer women within and across all countries (Bobo et al., Health Policy Plan, 2021).

Rinnit original analysis, not peer-reviewed. Author: Baraa Alnahhal, MD (ORCID 0009-0003-5995-0211). Study data, code and report: https://doi.org/10.5281/zenodo.24142462. Pre-specified analysis plan: https://doi.org/10.5281/zenodo.24136796.

How this study was planned, checked and reviewed: How Rinnit Research Studies Are Done.

Key findings

• The median blood-pressure gap in antenatal care is 4.3% across the 48 countries with a survey from 2015 to 2025 (interquartile range 1.9% to 10.3%).

• The gap is lowest in Armenia (2016) and Tajikistan (2023), at 0.5%, and highest in Burundi (2016), at 50.7%.

• In 13 of the 48 countries the gap is 10% or more. In 26 it is under 5%.

• Counting all women with a recent birth, whether or not they received antenatal care, a median of 13.0% had no blood pressure measurement during pregnancy (interquartile range 4.7% to 21.8%, 47 countries; the Philippines 2022 survey does not report this figure).

• In 52 countries with surveys at least five years apart, between 1999 and 2025, the gap narrowed by 5 percentage points or more in 26 and moved less than 5 points in 25. It widened by 5 points or more only in Niger, from 14.2% in 2006 to 30.4% in 2012 (+16.2 points). The median change was -5.4 points.

• Among women who received antenatal care, median coverage across the 48 countries was 95.8% for blood pressure measurement, 89.7% for a blood sample and 87.3% for a urine sample.

• Blood pressure coverage was 5 or more percentage points higher than urine-sample coverage in 28 of the 48 countries, and 5 or more points higher than blood-sample coverage in 19.

How large is the blood-pressure gap in antenatal care by country?

The blood-pressure gap in antenatal care has a median of 4.3% (interquartile range 1.9% to 10.3%) across the 48 countries with a latest national survey from 2015 to 2025, spanning from 0.5% in Armenia (2016) and Tajikistan (2023) to 50.7% in Burundi (2016). In 13 of these countries the gap is 10% or more, and in 26 it is under 5%. This study does not treat differences of less than 5 percentage points between countries as real differences, because survey estimates carry sampling error.

The six largest gaps are in Burundi (2016) at 50.7%, Uganda (2016) at 29.0%, Democratic Republic of the Congo (2023) at 28.3%, Mozambique (2022) at 27.5%, Tanzania (2022) at 23.8% and Afghanistan (2015) at 21.1%. The other seven countries at 10% or more are Madagascar (2021) at 17.1%, Angola (2023) at 15.9%, Papua New Guinea (2017) at 13.1%, Malawi (2024) at 11.3%, Pakistan (2017) at 10.8%, Ethiopia (2024) at 10.7% and Timor-Leste (2016) at 10.1%.

At the other end, 26 countries have a gap below 5%. They run from Haiti (2016) at 4.5%, Côte d'Ivoire (2021) at 4.3%, Liberia (2019) at 4.2%, India (2020) at 3.8%, Sierra Leone (2019) at 3.4% and Rwanda (2025) at 3.1% down to South Africa (2016) at 0.7%, and Armenia (2016) and Tajikistan (2023) at 0.5%.

Table 1: Main ranking of the blood-pressure gap in antenatal care (48 countries, latest survey 2015 to 2025)

Rank	Country	Survey year	Blood pressure measured, % of women who received antenatal care	Gap %	No blood pressure measurement, % of all women with a recent birth	Urine sample %	Blood sample %
1	Burundi	2016	49.3	50.7	51.0	28.3	88.3
2	Uganda	2016	71.0	29.0	30.3	38.4	93.6
3	Democratic Republic of the Congo	2023	71.7	28.3	39.6	57.5	61.3
4	Mozambique	2022	72.5	27.5	36.7	57.2	86.2
5	Tanzania	2022	76.2	23.8	31.6	68.9	91.4
6	Afghanistan	2015	78.9	21.1	49.8	40.0	30.7
7	Madagascar	2021	82.9	17.1	26.9	34.1	47.8
8	Angola	2023	84.1	15.9	34.7	76.7	81.1
9	Papua New Guinea	2017	86.9	13.1	34.7	45.2	77.6
10	Malawi	2024	88.7	11.3	13.4	47.7	90.4
11	Pakistan	2017	89.2	10.8	21.0	70.1	70.7
12	Ethiopia	2024	89.3	10.7	30.2	87.6	88.2
13	Timor-Leste	2016	89.9	10.1	22.5	60.4	57.5
14	Mauritania	2020	92.2	7.8	17.8	88.3	78.3
15	Bangladesh	2022	92.4	7.6	14.5	81.4	79.7
16	Guatemala	2015	92.5	7.5	11.0	72.7	70.0
17	Nigeria	2024	92.5	7.5	31.9	88.4	88.6
18	Guinea	2018	93.0	7.0	18.7	83.7	81.2
19	Myanmar	2016	93.4	6.6	17.2	64.8	66.8
20	Albania	2017	94.1	5.9	16.0	98.3	98.7
21	Nepal	2022	94.5	5.5	8.0	89.9	86.1
22	Mali	2023	94.6	5.4	18.1	82.3	86.9
23	Haiti	2016	95.5	4.5	13.9	83.8	85.7
24	Côte d'Ivoire	2021	95.7	4.3	8.5	86.9	88.2
25	Liberia	2019	95.8	4.2	5.5	91.4	96.3
26	India	2020	96.2	3.8	9.4	93.3	94.3
27	Sierra Leone	2019	96.6	3.4	4.6	84.3	95.1
28	Rwanda	2025	96.9	3.1	7.4	98.1	98.8
29	Zimbabwe	2015	97.3	2.7	10.6	67.2	98.7
30	Cameroon	2018	97.5	2.5	15.3	91.4	97.2
31	Benin	2017	97.7	2.3	13.0	92.9	89.0
32	Ghana	2022	97.9	2.1	3.8	98.8	98.7
33	Indonesia	2017	98.0	2.0	4.0	41.8	53.3
34	Jordan	2023	98.0	2.0	4.9	94.9	96.0
35	Senegal	2023	98.0	2.0	3.7	97.4	96.6
36	Zambia	2024	98.1	1.9	3.1	79.9	94.0
37	Kenya	2025	98.3	1.7	3.6	96.4	97.5
38	Gabon	2019	98.4	1.6	4.7	95.9	97.1
39	Burkina Faso	2021	98.6	1.4	2.5	87.7	93.7
40	Lesotho	2023	98.6	1.4	4.7	97.3	98.1
41	Cambodia	2021	98.7	1.3	2.5	75.7	88.3
42	Philippines	2022	98.8	1.2	not reported	87.8	86.5
43	Maldives	2016	99.1	0.9	2.1	99.2	99.2
44	Colombia	2015	99.2	0.8	3.2	97.4	98.0
45	Gambia	2019	99.2	0.8	1.1	93.9	98.0
46	South Africa	2016	99.3	0.7	7.1	99.4	99.4
47	Armenia	2016	99.5	0.5	0.6	99.5	99.5
48	Tajikistan	2023	99.5	0.5	19.2	99.3	99.4

Source: Rinnit analysis of national estimates from The DHS Program (indicators RH_ANCS_W_BLP, RH_ANCS_W_URN, and RH_ANCS_W_BLS). Data and code: https://doi.org/10.5281/zenodo.24142462

How does the blood-pressure gap in antenatal care compare with all women who gave birth?

The percentage of all women with a recent birth who had no blood pressure measurement during pregnancy has a median of 13.0% (interquartile range 4.7% to 21.8%) across 47 countries surveyed between 2015 and 2025, compared with the median blood-pressure gap of 4.3% (interquartile range 1.9% to 10.3%) among women who received antenatal care across 48 countries. The Philippines (2022) survey reports a gap of 1.2% among women who received antenatal care but no figure for all women with a recent birth.

The two figures count different groups. The blood-pressure gap counts only women who received antenatal care for their most recent birth. The all-women figure also counts women who received no antenatal care at all.

In some countries the all-women figure is far higher than the gap. In Afghanistan (2015) the gap is 21.1%, but 49.8% of all women with a recent birth had no blood pressure measurement. The same pattern appears in Nigeria (2024), at 7.5% and 31.9%, Ethiopia (2024), at 10.7% and 30.2%, and Tajikistan (2023), at 0.5% and 19.2%. In other countries the two figures are close: 50.7% and 51.0% in Burundi (2016), 0.5% and 0.6% in Armenia (2016), and 0.8% and 1.1% in Gambia (2019).

How has the blood-pressure gap in antenatal care changed over time?

The blood-pressure gap in antenatal care changed by a median of -5.4 percentage points across 52 countries with national surveys at least five years apart, narrowing by 5 percentage points or more in 26 countries, widening by 5 percentage points or more in 1 country, and moving by less than 5 percentage points in 25 countries.

The four largest reductions were in Cambodia (36.0% in 2000 to 1.3% in 2021, -34.7 points), India (37.5% in 2006 to 3.8% in 2020, -33.7 points), Nepal (38.9% in 2001 to 5.5% in 2022, -33.4 points) and Rwanda (35.1% in 2000 to 3.1% in 2025, -32.0 points). Ten more countries cut the gap by more than 10 points: Ethiopia (31.5% in 2000 to 10.7% in 2024, -20.8 points), Kenya (18.6% in 2003 to 1.7% in 2025, -16.9 points), Uganda (45.8% in 2000 to 29.0% in 2016, -16.8 points), Liberia (18.9% in 2007 to 4.2% in 2019, -14.7 points), Nigeria (21.5% in 2003 to 7.5% in 2024, -14.0 points), Zambia (15.7% in 2002 to 1.9% in 2024, -13.8 points), Egypt (20.8% in 2000 to 7.1% in 2014, -13.7 points), Tanzania (36.0% in 2004 to 23.8% in 2022, -12.2 points), Madagascar (29.3% in 2004 to 17.1% in 2021, -12.2 points) and Pakistan (21.1% in 2006 to 10.8% in 2017, -10.3 points).

Niger is the only one of the 52 countries where the gap widened by 5 points or more, from 14.2% in 2006 to 30.4% in 2012 (+16.2 points). In the other 25 countries the gap moved by less than 5 points.

Table 3: Change over time in the blood-pressure gap in antenatal care for countries that moved 5 percentage points or more (27 of 52 countries)

Country	First survey year	Gap % then	Latest survey year	Gap % now	Change in points
Cambodia	2000	36.0	2021	1.3	-34.7
India	2006	37.5	2020	3.8	-33.7
Nepal	2001	38.9	2022	5.5	-33.4
Rwanda	2000	35.1	2025	3.1	-32.0
Ethiopia	2000	31.5	2024	10.7	-20.8
Kenya	2003	18.6	2025	1.7	-16.9
Uganda	2000	45.8	2016	29.0	-16.8
Liberia	2007	18.9	2019	4.2	-14.7
Nigeria	2003	21.5	2024	7.5	-14.0
Zambia	2002	15.7	2024	1.9	-13.8
Egypt	2000	20.8	2014	7.1	-13.7
Tanzania	2004	36.0	2022	23.8	-12.2
Madagascar	2004	29.3	2021	17.1	-12.2
Pakistan	2006	21.1	2017	10.8	-10.3
Mali	2001	15.4	2023	5.4	-10.0
Philippines	2003	10.9	2022	1.2	-9.7
Sierra Leone	2008	13.1	2019	3.4	-9.7
Indonesia	2003	10.5	2017	2.0	-8.5
Malawi	2000	19.2	2024	11.3	-7.9
Lesotho	2004	8.7	2023	1.4	-7.3
Turkey	2003	10.4	2013	3.3	-7.1
Haiti	2000	11.5	2016	4.5	-7.0
Guinea	2005	13.7	2018	7.0	-6.7
Bangladesh	2004	14.3	2022	7.6	-6.7
Chad	2004	27.0	2014	20.8	-6.2
Tajikistan	2012	6.4	2023	0.5	-5.9
Niger	2006	14.2	2012	30.4	+16.2

Source: Rinnit analysis of national estimates from The DHS Program (indicator RH_ANCS_W_BLP). Data and code: https://doi.org/10.5281/zenodo.24142462

How does blood pressure measurement in antenatal care compare with urine and blood tests?

Blood pressure measurement in antenatal care reached a median coverage of 95.8% across the 48 countries in the main ranking (2015 to 2025), compared with a median coverage of 89.7% for having a blood sample taken and 87.3% for having a urine sample taken. Blood pressure coverage was 5 or more percentage points higher than urine-sample coverage in 28 of the 48 countries, and 5 or more points higher than blood-sample coverage in 19.

In some countries blood pressure coverage is far ahead of both tests. In Indonesia (2017), 98.0% of women who received antenatal care had their blood pressure measured, 41.8% had a urine sample taken and 53.3% had a blood sample taken. In Afghanistan (2015) the figures are 78.9%, 40.0% and 30.7%, and in Madagascar (2021) they are 82.9%, 34.1% and 47.8%.

A few countries with large blood-pressure gaps show the opposite for blood samples. In Burundi (2016), 88.3% of women who received antenatal care had a blood sample taken, but 49.3% had their blood pressure measured and 28.3% had a urine sample taken. In Uganda (2016) the figures are 93.6%, 71.0% and 38.4%, and in Tanzania (2022) they are 91.4%, 76.2% and 68.9%.

How does the blood-pressure gap in antenatal care vary by region?

The median blood-pressure gap in antenatal care is 4.2% across 29 countries in Sub-Saharan Africa and 5.5% across 11 countries in South & Southeast Asia in the 48-country main ranking (2015 to 2025). The other four regions have only one to three countries each in the main ranking, so those countries are reported individually.

In Sub-Saharan Africa the gap ranges from 0.7% in South Africa (2016) to 50.7% in Burundi (2016). In South & Southeast Asia it ranges from 0.9% in the Maldives (2016) to 21.1% in Afghanistan (2015).

The remaining eight countries come from regions with too few surveyed countries to describe a regional pattern:

• North Africa/West Asia/Europe: Armenia (2016) has a gap of 0.5%, Jordan (2023) has a gap of 2.0%, and Albania (2017) has a gap of 5.9%.

• Latin America & Caribbean: Colombia (2015) has a gap of 0.8%, Haiti (2016) has a gap of 4.5%, and Guatemala (2015) has a gap of 7.5%.

• Central Asia: Tajikistan (2023) has a gap of 0.5%.

• Oceania: Papua New Guinea (2017) has a gap of 13.1%.

Table 4: Blood-pressure gap in antenatal care in the two regions with enough countries to compare (main ranking, 2015 to 2025)

Region	Countries	Median gap %	Lowest %	Highest %
Sub-Saharan Africa	29	4.2	0.7	50.7
South & Southeast Asia	11	5.5	0.9	21.1

Source: Rinnit analysis of national estimates from The DHS Program (indicator RH_ANCS_W_BLP). Data and code: https://doi.org/10.5281/zenodo.24142462

What do older surveys show about the blood-pressure gap in antenatal care?

Twenty-four additional countries with a latest national survey conducted between 2000 and 2014 show blood-pressure gaps in antenatal care ranging from 0.1% in the Dominican Republic (2013), the Kyrgyz Republic (2012), and Sao Tome and Principe (2008) to 30.4% in Niger (2012). These surveys date from before 2015, so they are reported separately in Table 2 and are not part of the 48-country main ranking.

Six of the 24 countries had a gap of 10% or more at their latest survey: Niger (2012) at 30.4%, Chad (2014) at 20.8%, Eritrea (2002) at 16.8%, Yemen (2013) at 14.4%, Comoros (2012) at 11.9% and Azerbaijan (2006) at 11.2%. Two had gaps between 5% and 10%: Morocco (2003) at 8.7% and Egypt (2014) at 7.1%. The other 16 had a gap below 5%.

Table 2: Older surveys not included in the main ranking (24 countries, latest survey 2000 to 2014)

Country	Survey year	Blood pressure measured %	Gap %
Niger	2012	69.6	30.4
Chad	2014	79.2	20.8
Eritrea	2002	83.2	16.8
Yemen	2013	85.6	14.4
Comoros	2012	88.1	11.9
Azerbaijan	2006	88.8	11.2
Morocco	2003	91.3	8.7
Egypt	2014	92.9	7.1
Guyana	2009	96.6	3.4
Turkey	2013	96.7	3.3
Togo	2013	96.8	3.2
Bolivia	2008	97.1	2.9
Congo	2011	97.7	2.3
Namibia	2013	97.7	2.3
Eswatini	2006	98.4	1.6
Nicaragua	2001	98.4	1.6
Honduras	2011	98.5	1.5
Turkmenistan	2000	99.2	0.8
Moldova	2005	99.4	0.6
Peru	2012	99.5	0.5
Ukraine	2007	99.7	0.3
Dominican Republic	2013	99.9	0.1
Kyrgyz Republic	2012	99.9	0.1
Sao Tome and Principe	2008	99.9	0.1

Source: Rinnit analysis of national estimates from The DHS Program (indicator RH_ANCS_W_BLP). Data and code: https://doi.org/10.5281/zenodo.24142462

How was this study done?

This study examined national estimates published by The DHS Program (Demographic and Health Surveys): 3,240 records from 212 surveys in 72 countries, covering survey years 1999 to 2025. The analysis followed a pre-specified plan that was published on Zenodo before the data was pulled on 11 November 2026 (Alnahhal, 2026). The study was conducted by Baraa Alnahhal, MD (ORCID 0009-0003-5995-0211) at Rinnit. It is a Rinnit original analysis and has not been peer-reviewed.

The analysis used The DHS Program's published national estimates for indicator RH_ANCS_W_BLP (blood pressure measured during antenatal care), with RH_ANCS_W_URN (urine sample taken) and RH_ANCS_W_BLS (blood sample taken) for comparison. No individual records were used. Each figure refers to births in the two years before the survey. When the ranking was repeated with a three-year birth window, no country's blood-pressure gap moved by more than 0.9 percentage points (rank correlation 0.996).

Countries with a latest survey from 2015 or later went into the main ranking (48 countries, survey years 2015 to 2025). The 24 countries whose latest survey dates from 2000 to 2014 are reported separately. Differences smaller than 5 percentage points, between countries or over time, are not described as real differences, because survey estimates carry sampling error. One change was made from the pre-specified analysis plan: summary statistics are rounded with halves going up (for example, 4.25 becomes 4.3). No country value changed. Gemini 4 Argon and Claude assisted with data handling and drafting, and the two models recalculated the tables independently with identical results. The raw data, the analysis code and the result tables are available at https://doi.org/10.5281/zenodo.24142462.

What can this study not tell us?

This descriptive study reports national survey percentages of women whose blood pressure was or was not measured during antenatal care, and cannot tell us why the blood-pressure gap exists or whether the gap causes maternal deaths or complications.

The analysis uses national estimates, not individual records, so it cannot examine differences within countries by region, facility, wealth or education. Survey years differ by country (2015 to 2025 in the main ranking and 2000 to 2014 in the older surveys), so each country's figure describes the two years before its own survey and the countries are not compared in the same year. The survey records whether blood pressure was measured during antenatal care for the most recent birth. It does not record how many times it was measured, whether the equipment was calibrated, or what care followed.

The figures also depend on what women remembered and reported about a pregnancy in the two years before the survey, so some measurements may have been forgotten or misreported. Countries without DHS surveys, including most high-income countries, are not covered.

What does the blood-pressure gap in antenatal care mean in practice?

A physician's interpretation by Baraa Alnahhal, MD, the study's author.

The blood-pressure gap in antenatal care means that a check which is very easy to do, and is part of basic antenatal care, is not reaching every woman who attends, in the view of the study's author. The four answers below are his own interpretation, not findings of the study.

What can go wrong when blood pressure is not measured at an antenatal visit?

It is very easy to measure a pregnant woman's blood pressure. In my own practice I have never seen a visit where we could not do it, because the devices were always there. If the check were missed, pre-eclampsia could go undetected, and the woman could face organ damage or a preterm birth.

What does it mean when a clinic takes blood samples but does not measure blood pressure?

Measuring blood pressure is part of basic antenatal care. A blood sample needs a laboratory. Blood pressure needs only a cuff. So when a clinic manages the blood sample and skips the blood pressure, the system is not delivering basic care. The survey data shows where this happens. It does not show why.

What can a pregnant woman and her family do to make sure her blood pressure is measured?

Do not leave the clinic without a paper with the results. If the woman is tired, the person with her, her husband or another family member, should have that paper in hand before they step out. She should also come to the check-up relaxed and well fed, because her food nourishes both her and her baby.

What should readers take from the difference between 4.3% and 13.0%?

People call these check-ups routine, but they are an essential line of defence for the lives of both mother and child.

Conclusion

The median blood-pressure gap in antenatal care is 4.3% across 48 countries with a survey from 2015 to 2025. The gap is 10% or more in 13 of those countries and reaches 50.7% in Burundi (2016). Among 52 countries with surveys at least five years apart, the gap narrowed by 5 percentage points or more in 26. The study cannot show why the check is missed.

The data, code and charts are free to reuse with credit to Rinnit: https://doi.org/10.5281/zenodo.24142462. For patient guides on high blood pressure in pregnancy, read Preeclampsia: Symptoms, Causes & What Helps and Gestational Hypertension: Managing BP in Pregnancy.

How should this study be cited?

This study should be cited as: Alnahhal B. The blood-pressure gap in antenatal care: a multi-country analysis of DHS surveys (Rinnit Research study 1). Version 1.0. Rinnit; 2026. https://doi.org/10.5281/zenodo.24142462

The pre-specified analysis plan is cited as: Alnahhal B. Analysis plan: The blood-pressure gap in antenatal care, a multi-country analysis of DHS surveys (Rinnit Research study 1). Version 1.0. Rinnit; 2026. https://doi.org/10.5281/zenodo.24136796

FAQ

What is the blood-pressure gap in antenatal care?

The blood-pressure gap in antenatal care is the percentage of women who received antenatal care for their most recent birth and did not have their blood pressure measured during that care. Across 48 countries with national surveys from 2015 to 2025, the median blood-pressure gap is 4.3% (interquartile range 1.9% to 10.3%).

Which countries have the largest and smallest blood-pressure gaps in antenatal care?

Burundi (2016) has the largest blood-pressure gap in the 2015 to 2025 main ranking at 50.7%, followed by Uganda (2016) at 29.0%, Democratic Republic of the Congo (2023) at 28.3%, Mozambique (2022) at 27.5%, Tanzania (2022) at 23.8%, and Afghanistan (2015) at 21.1%. Armenia (2016) and Tajikistan (2023) have the smallest gap at 0.5%, followed by South Africa (2016) at 0.7%, Colombia (2015) and Gambia (2019) at 0.8%, and the Maldives (2016) at 0.9%, though differences smaller than 5 percentage points are not considered real differences.

What share of all women with a recent birth had no blood pressure measurement during pregnancy?

Across 47 countries in the 2015 to 2025 main ranking, a median of 13.0% (interquartile range 4.7% to 21.8%) of all women with a recent birth had no blood pressure measurement during pregnancy, whether or not they attended antenatal care. The Philippines (2022) survey reported a 1.2% blood-pressure gap among women who received antenatal care but did not report the figure for all women with a recent birth.

How has the blood-pressure gap in antenatal care changed over time?

Across 52 countries with repeat surveys at least five years apart, the blood-pressure gap changed by a median of -5.4 percentage points. The gap narrowed by 5 percentage points or more in 26 countries, led by Cambodia (36.0% in 2000 to 1.3% in 2021, -34.7 points) and India (37.5% in 2006 to 3.8% in 2020, -33.7 points). It widened by 5 percentage points or more in 1 country (Niger, 14.2% in 2006 to 30.4% in 2012, +16.2 points) and moved less than 5 percentage points in 25 countries.

How does blood pressure measurement compare with urine and blood tests during antenatal care?

Median antenatal care coverage across the 48 countries in the main ranking (2015 to 2025) was 95.8% for blood pressure measurement, 89.7% for a blood sample taken, and 87.3% for a urine sample taken. Blood pressure coverage exceeded urine-sample coverage by 5 percentage points or more in 28 countries and exceeded blood-sample coverage by 5 percentage points or more in 19 countries.

What proportion of global maternal deaths are caused by hypertensive disorders?

Global maternal mortality analyses show that hypertensive disorders caused 16% of maternal deaths (80% uncertainty interval 14% to 19%) between 2009 and 2020, after haemorrhage (27%) and indirect obstetric deaths (23%). In an earlier analysis of 60,799 maternal deaths across 417 datasets from 115 countries for 2003 to 2009, hypertensive disorders accounted for 14.0% of maternal deaths (95% uncertainty interval 11.1% to 17.4%) (Say et al., Lancet Glob Health, 2014).

Does this study show that the blood-pressure gap causes maternal deaths or complications?

The study is descriptive: it shows what the national survey figures are and does not show why the blood-pressure gap exists or whether the gap causes maternal deaths or complications. The study reports national aggregate coverage from 212 surveys across 72 countries (1999 to 2025) without linking aggregate survey gaps to clinical outcomes.

References

1. Cresswell JA, Alexander M, Chong MYC, et al. Global and regional causes of maternal deaths 2009-20: a WHO systematic analysis. Lancet Glob Health. 2025;13(4):e626-e634. PMID 40064189. https://doi.org/10.1016/S2214-109X(24)00560-6

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Medical disclaimer

This article is for general education and does not replace advice from your doctor, pharmacist or another qualified healthcare professional. If you have severe or sudden symptoms, seek emergency care right away.