Safe motherhood in South Asia: current status and strategies for change.

Already large, the population of South Asia is growing rapidly. Stable and high levels of fertility along with declining mortality have built a population in which approximately 45% of the total is younger than 15 years old. Women in South Asia comprise almost one-third of the world's female population. The average woman in the region marries young and begins to bear children shortly thereafter. While fertility has been declining in most of India and Bangladesh, and is already relatively low in Sri Lanka, levels of fertility have not declined dramatically in Nepal and Pakistan. Contraception is used at moderate levels in India and Bangladesh, but almost not at all in Nepal and Pakistan. Contraceptive use rates in the region, with the exception of Sri Lanka, remain far lower than the average of less developed countries which is 45%. Female life expectancy in South Asia does not exceed that of males by very much and is lower than that of males in Bangladesh, Maldives, and Nepal. High levels of maternal mortality and excess mortality among females during the postneonatal period and between ages 1 and 5 are principal reasons for the situation. Gender differentials in mortality in South Asia are explained followed by consideration of health, fertility, and women's status, and strategies needed to promote safe motherhood.