Over the past quarter of a century, there has been some important progress in improving the health of mothers and their newborn babies. Globally, there has been an impressive 44 percent drop in the number of maternal deaths since 1990, with lots of work going into achieving this. But the results have been patchy, to say the least.

While clearly the drop in maternal deaths is to be celebrated, as more women have access to the care and treatment they require, the level by which it has decreased “fell far short” of the target set by the United Nations under its millennium development goals in 2000. These aimed to see the number of deaths drop by 75 percent by 2015. They are however close to hitting another of their maternal health goals of seeing three-quarters of pregnant women being assisted by a skilled health professional, as it is thought that 71 percent of pregnant women were assisted in 2014.

But these figures also hide the disparate health care afforded to women between the developed and developing nations. “Some countries and groups of women saw little or no progress, despite significant global political attention on maternal health,” write the authors of the report, made up of six papers assessing the changes in maternal health globally between 1990 and 2015, and published in The Lancet. “Since 1990, the gap between the group of countries with the highest level of maternal mortality and the group with the lowest has doubled in size.”

They found that there was a shocking 200-fold difference between these two groups, with the chances of a woman dying from childbirth over the course of her life dropping from 1 in 4,900 in the wealthiest nations to an appalling 1 in 36 in Sub-Saharan Africa. The problem here is not that we do not know how to reduce these deaths – the data from the developed world shows that many of these are preventable – it is simply a matter of implementing them in the more rural areas of the planet and enabling access for all mothers.

It is true that the number of pregnant women who have assistance has risen dramatically, but these figures show nothing about the quality of care that they receive, or the amount. The report highlights that in some African countries, more than two-thirds of maternity centers lack basic facilities such as running water and electricity.

And it still leaves a whopping 53 million women who have zero care at the time they are giving birth. More obviously needs to be done in helping these people out, with the report recommending that more than 18 million health care workers will be required by 2030 to hit the stated goals, but more also needs to be done about promoting contraception in regions that have high fertility rates.