A pregnant woman stands on a scale before receiving a prenatal exam at the Maternity Outreach Mobile in Phoenix, Arizona October 8, 2009. Credit: Reuters/Joshua Lott

Deaths from complications during pregnancy and childbirth have fallen by a third in the past two decades but 1,000 women still die needlessly every day, the World Health Organization said Wednesday.

Women in poorer countries are 36 times more likely to die from pregnancy-related causes than those in the rich nations, the WHO said, announcing maternal mortality figures that remain far above the United Nations' flagship targets.

We must do more to reach out to those who are most at risk, UNICEF Executive Director Anthony Lake said, calling for more attention to obstetric care in rural areas, conflict zones and among women living with the HIV virus that causes AIDS.

Some 99 percent of the 358,000 maternal deaths reported in 2008 were in developing countries, and more than half were in sub-Saharan Africa, according to the report launched ahead of a summit in New York on the Millennium Development Goals.

For maternal mortality rates to hit the U.N. target, there would need to be an annual decline in deaths of 5.5 percent from now until 2015. The rate of decline since 1990, when there were 546,000 pregnancy-related deaths, was 2.3 percent.

U.N. Secretary-General Ban Ki-moon said earlier this week that tens of billions of dollars per year were required to achieve the health-related Millennium Development Goals by 2015 as the world has pledged to do.

The four major causes of maternal mortality are severe bleeding after childbirth, infections, hypertensive disorders and unsafe abortions, according to the WHO figures.

These complications cause a lot of deaths which can easily be prevented, Ban told a news conference. We cannot just accept this intolerable, unacceptable situation where many millions of women die needlessly.

The overall improvement seen since 1990 was attributed to better training for midwives, improved family planning services and better delivery and post-natal care in hospitals and health clinics worldwide.

World Bank Vice President Tamar Manuelyan Atinc said helping poor families access medical care, including family planning, emergency obstetric treatment and post-natal monitoring, was fundamental to making a further dent in maternal mortality.