An international drive to cut the global toll of deaths among women in childbirth has made almost zero progress after 15 years, experts said yesterday. They blame governments and agencies for seeking a "silver bullet" to solve the problem instead of building up desperately needed local health services.

Children could be protected by vaccination against infectious disease but there was no equivalent measure to reduce the 500,000 maternal deaths that still occur every year, according to Anne Starrs, vice-president of Family Health International. She said: "You cannot give a woman a pill to prevent an obstetric death. You need a fully functioning health system. People have been looking for a silver bullet and it doesn't exist."

The World Health Organisation launched its Safe Motherhood initiative 20 years ago but a series of papers, published today in the UK medical journal The Lancet to mark the anniversary, show that the Millennium Development Goal of cutting the maternal death rate by 75 per cent between 1990 and 2015 remains a pipe dream.

Deaths of mothers in childbirth are almost unchanged since 1990. In 2005, 536,000 women died due to complications of pregnancy or labour compared with 576,000 15 years earlier, according to figures published by UNFPA, the United Nations Population Fund, and other agencies today.

Ninety-nine per cent of the deaths occur in the developing world. In sub- Saharan Africa more than 900 women die for every 100,000 live births, a rate 100-fold higher than in Europe where the death rate is nine per 100,000 births.

Thoraya Ahmed Obaid, executive director of UNFPA said what was needed to save women from dying was well known – skilled birth attendants [midwives], emergency obstetric care and family planning – but in vast tracts of the world these basic services were still not available.

She said: "In this 21st century no woman should die giving life. It is unacceptable that one woman dies every minute during pregnancy and childbirth when proven interventions exist. Millions of lives are at stake and we must act now."

Professor Ken Hill of Harvard University said the "most likely estimate" suggested maternal mortality had declined globally at 0.4 per cent a year since 1990,. This was more than 10 times more slowly than necessary (5.5 per cent a year) to achieve the 2015 Millennium Development Goal.

He said: "There has been substantial progress in some countries such as Korea and Mexico but in sub-Saharan Africa it is not falling."

Figures show that where women have access to family planning, contraception and abortion, maternal deaths fall by a third and child deaths by 20 per cent.

Globally abortions have fallen from 46 million to less than 42 million between 1995 and 2003, as access to contraception has improved.

Iqbal Shah, of the World Health Organisation, said : "Where contraception is available, as in western Europe, abortion rates are low, and where it is becoming so as in eastern Europe, abortion rates are falling."

But legal restrictions meant half of all abortions were unsafe – amounting to 20 million worldwide – and they killed one woman every eight minutes.

Beth Fredrick of the International Women's Health Coalition in New York said: "One fact stands out: safe and legal abortion saves women's lives. There is no acceptable reason to allow women to die, fall ill or become infertile as a result of unsafe abortion."

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