In 2008 the number of African women who died from pregnancy and child birth was much higher than the number of casualties from all the major conflicts in Africa combined. Maternal mortality continues to be the major cause of death among women of reproductive age (15-49) in Sub-Saharan Africa (SSA). This report looks at the performance of sub Saharan African countries in meeting reproductive health targets in 47 countries and ranks them using a set of ten indicators in order of the highest to lowest risk. It highlights the need to increase the level of investment in reproductive health, step up policy reform and implementation, expand access to services in rural areas, strengthen health systems, promote the realization of rights and abolish retrogressive cultural practices that perpetuate gender inequities and put the lives of women and girls at risk. The first part of the report discusses the methodology and the background and looks at the factors contributing to reproductive risk in sub Saharan Africa. The second part looks at the status of the ten indicators and highlights factors that have a bearing on the same. The third part presents a call to action highlighting key actions that would contribute to improving maternal health in sub Saharan Africa.