Despite various programmes aimed at reducing the maternal mortality ratio (MMR) and improving reproductive health globally, and in Malawi especially, the 2000 Malawi Demographic and Health Survey (DHS) reported an MMR for Malawi as 1221 deaths per 100 000 live births. This represented an almost 80% rise from the 620 maternal deaths/100 000 live births estimated in the 1992 DHS. The possible reasons behind the rise in the MMR include: the growing HIV/AIDS pandemic in Malawi with an estimated infection rate of 14%; and the deteriorating healthcare situation and inherent inaccuracies in the estimation of maternal mortality. Continued surveillance and identification of factors responsible for the deterioration of Malawi's MMR are suggested. It is necessary to design, implement and evaluate corrective measures in order to improve the situation.