Women continue to die from complications of pregnancy and childbirth, and this is unacceptable. While Africa has made progress in reducing maternal mortality since 2000, the region still needs a twelve-fold increase in the annual reduction rate to meet the Sustainable Development Goal, according to the estimates from the United Nations Maternal Mortality Estimation Interagency Group.
About 92% of maternal deaths occur in low- and lower-middle-income countries, most of which are preventable.
“Every two minutes, a woman dies from complications related to pregnancy and childbirth. That’s over 700 women a day, and nearly 260,000 women a year,” said Dr Shamma Al Mazrouei from the Mohamed bin Zayed Foundation for Humanity. “Over 70% of these maternal deaths occur in sub-Saharan Africa, and almost all could be prevented if women had access to quality care before, during, and after childbirth.”
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Across the African region, an estimated 178,000 women die each year from complications related to pregnancy or childbirth. Nearly one million newborns also die annually, many from causes that could be prevented with timely and quality healthcare. In nine particularly affected countries in sub-Saharan Africa, maternal mortality ratios exceed 500 deaths per 100,000 live births in some cases. In 2023 alone, an estimated 712 women died every day during pregnancy or childbirth, according to a United Nations report.
This translates to roughly one maternal death every two minutes, amounting to about 260,000 deaths globally that year.
“Mothers should not be dying from causes we know how to prevent,” Dr Al Mazrouei said. “Today, we understand what works to save the lives of mothers and newborns. We know that by investing in skilled health workers, strong primary healthcare systems, and scaling the use of proven innovations, we can give millions more mothers and babies the chance of a healthy future,” she said.
Dr Al Mazrouei said maternal and newborn mortality remains one of the most solvable global health challenges, yet investment has not kept pace with the scale of the problem. She said that despite carrying a disease burden three to five times greater than many other health priorities, maternal and newborn health still receives only a fraction of the funding. According to her, part of the reason is that most deaths occur in low-income countries with fragile health systems or in regions affected by conflict. This concentration in the world’s most vulnerable settings, she said, has contributed to maternal and newborn mortality being overlooked and chronically underfunded.
She said that improving maternal and newborn survival requires sustained investments in the fundamentals of healthcare, including trained health workers, well-equipped facilities, reliable medical supplies, and effective referral systems. “These are not quick wins or one-time campaigns. It requires slow and consistent support. But when countries and partners make these investments, the results are transformative for mothers, babies, and entire communities.”
From a philanthropic perspective, she said that maternal and newborn health is one of the clearest examples of where investment saves lives. The solutions are well established. The challenge is ensuring they reach every mother and newborn who needs them.
Alice Kang’ethe, the CEO of the Beginnings Fund, said maternal and newborn deaths across Africa remain a tragedy because most of them are preventable.
“Every life is precious, and to lose a mother when she is bringing forth life is devastating. It is not only the loss of a woman’s life; it is the loss of a mother, a daughter, a sister, often the backbone of a family,” Kang’ethe said. “The fact that a mother or newborn dies from preventable causes is not a failure of science; it is a failure of delivery and equity. We know how to prevent most of these deaths. The question is whether we are willing to ensure proven solutions reach every woman, regardless of where she lives.”
“With both a preventable problem and scalable solution in hand, the fund aims to support government initiatives to make well-trained health care workers and low-cost equipment innovations the norm in African countries, building on the political will to strengthen health systems and talent pipelines to sustain improvement,” she said.
The World Health Organisation reports that maternal deaths increase when women lack access to quality healthcare services, particularly during pregnancy and around the time of delivery. The most common causes of maternal deaths include severe bleeding (haemorrhage), high blood pressure disorders such as pre-eclampsia, infections, unsafe abortion and obstructed labour. For newborns, leading causes include preterm birth complications, sepsis, birth trauma and congenital anomalies.
Many countries still struggle to deliver basic services, skilled birth attendance, emergency obstetric care, and essential medicines that could save lives.
Kang’ethe said that improving outcomes for mothers and newborns requires stronger health systems, including investing in trained midwives and healthcare workers, equipping facilities with essential supplies and innovations, ensuring reliable referral systems, and integrating maternal and newborn services into national health strategies.
“First, we must invest in the health systems that deliver maternal and newborn care. With a preventable problem and scalable solutions, this means investing in trained midwives and health workers, equipping facilities with essential supplies, equipment, and innovations, ensuring reliable referral pathways, and integrating maternal and newborn services into national health strategies.”
“Second, financing must match the scale of the challenge. Maternal and newborn health remains one of the most addressable yet underfunded areas in global health. Sustained domestic leadership, backed by catalytic and collaborative financing from partners, is essential to close gaps and protect progress. Finally, we must treat maternal survival as a core development priority. When a mother survives and thrives, families are stronger, children are healthier, and communities are more resilient. Improving outcomes for mothers and newborns is not only a health imperative; it is foundational to economic and social progress,” she said.
“This is precisely the moment to double down, not step back,” said Kang’ethe.
“The fact that we missed the MDG target and are now off track on the SDGs is a signal that maternal and newborn health has not consistently received the level of political and financial prioritisation it requires,” she said. “This is not due to a lack of knowledge. We know that up to 75% of maternal and newborn deaths in Africa are preventable when skilled health workers are equipped to provide quality care. We know that healthcare systems can prevent the vast majority of maternal and newbornchild deaths.”
She said what has been missing is sustained, aligned investment and delivery of proven high-impact interventions at scale.
“To accelerate momentum, maternal and newborn health must be positioned not as a narrow health issue, but as foundational to economic growth, resilience, and human capital development. When women survive and thrive, children are more likely to reach their potential, and communities are stronger.”
She also cautioned against reducing health funding at a time when progress remains fragile. According to global health data, the maternal mortality ratio in conflict-affected areas reaches 504 deaths per 100,000 live births, compared with 99 deaths per 100,000 live births in more stable settings. The maternal death rate in countries experiencing humanitarian crises, such as Sudan, South Sudan, and Somalia, is more than twice that of the global average. Without urgent action, health agencies warn that pregnant women in these settings will continue to face devastating consequences.
“We must also protect funding for health systems, especially in fragile contexts. Cuts at this stage risk reversing decades of progress. This is precisely the moment to double down, not step back,” she said.
“Health systems are strongest when solutions reflect local context.”
The Beginnings Fund engages philanthropic partners and African governments to pool funds to support organisations and initiatives that improve maternal and newborn health. The program aims to increase the number, quality, and distribution of maternal and newborn healthcare workers, increase access to evidence-based, low-cost interventions and solutions, and strengthen critical components that enable quality care, such as data systems, emergency transportation, and referral networks. In this approach, mothers and babies are given the best possible chance for a healthy future.
“The Beginnings Fund was created around a simple premise: maternal and newborn deaths are largely preventable, and scalable high-impact solutions already exist,” Kang’ethe said. “Our strategy takes a targeted and collaborative approach to partnerships to ensure countries have the people, products, and systems in place to provide quality, lifesaving care.”
She said the fund works closely with governments to ensure investments strengthen national health systems. “We work hand-in-hand with governments to ensure investments are country-led and embedded in national strategies. This is not a parallel programme. It is about reinforcing and building on national systems so that quality care becomes the norm, not the exception.”
Kang’ethe said that the fund prioritises strengthening the core elements of resilient health systems.
“We focus on trained healthcare workers, functional primary healthcare facilities, strong data systems and access to critical medicines and equipment, from oxytocin and infection prevention tools to newborn CPAP and oxygen therapy. These are not experimental solutions; they are proven interventions that save lives.”
She said the fund also acts as a catalytic platform to bring partners together.
“By pooling resources and expertise with partners, we aim to attract additional financing and align efforts around shared priorities. Sustainable impact at scale requires collaboration. Our goal is not only to save 300,000 lives by 2030 but to change the trajectory of maternal and newborn health on the continent to end preventable deaths,” she said. “It is to help build systems capable of protecting millions more well beyond that date.”
“Equity is central to our approach,” Kang’ethe added.
She said that is why the Fund works through national governments to identify priority regions with the highest burden and the greatest gaps in access. Investments are targeted to those areas first, strengthening maternal and newborn healthcare, upgrading sub-national level facilities, and improving referral pathways so complications can be managed in time.
Kang’ethe said that country ownership remains central to the fund’s approach.”Health systems are strongest when solutions reflect local context. We support governments in expanding the workforce and number of health workers caring for mothers, strengthening data systems, and embedding maternal and newborn care into broader reforms. Our role is to help catalyse, support and accelerate what works, with government leadership and sustainability built in from the outset,” she said.
“Collaboration is at the heart of what we do.”
Against this backdrop, the Mohamed bin Zayed Foundation for Humanity has emerged as a key supporter of maternal and newborn health programmes across the continent. Foundations like the Mohamed bin Zayed Foundation for Humanity and initiatives such as the Beginnings Fund are supporting country-led programs that expand access to quality care, strengthen health systems, and target underserved communities.
Humanitarian funding cuts are having a severe impact on health care in many regions, forcing countries to cut essential services for maternal, newborn and child health. The funding cuts have forced facility closures, loss of health workers, and disruptions to supply chains for critical medicines and supplies. These shortages affect life-saving treatments for conditions such as haemorrhage, pre-eclampsia and malaria, which remain major causes of maternal deaths. In a joint statement, the WHO and UNICEF warned that the rollback of essential health services could reverse decades of progress in reducing maternal mortality.
“As a Foundation, one of our primary goals is to help ensure mothers and newborns in low and middle-income countries survive and remain healthy before, during and after birth,” added Dr Al Mazrouei. “This means working directly with countries to strengthen the conditions that allow women to receive safe, high-quality care – no matter where they live.”
She explained that the foundation co-launched the Beginnings Fund, a pooled fund that works directly with African governments to invest in building the maternal and newborn health workforce, deploying lifesaving products, and ensuring resilient health systems. According to Dr Al Mazrouei, this approach supports national systems, so quality care for mothers and babies becomes the norm, not the exception.
She added that the foundation invests in the reliable delivery of essential medicines and ensures hospitals and clinics are equipped to provide quality, dignified care. “We have seen first-hand that when facilities are prepared to manage complications and health workers have the tools they need, birth outcomes improve dramatically,” she said. The foundation’s role, Dr Al Mazrouei said, is collaborative and catalytic. “We aim to help mobilise resources, reduce fragmentation, and support governments to scale solutions that we know can give mothers and babies the best chance for a healthy future.”
Aligning financing with national plans embeds progress and makes improvements sustainable.
“Collaborative funds can’t replace the scale of global health financing that is now at risk,” said Dr Al Mazrouei. “But they can play a role in helping countries and partners navigate this moment. By bringing together governments and donors around shared priorities, they help pool resources, reduce fragmentation, and direct funding toward areas where it can have the greatest impact. They also help demonstrate the impact of sustained investment, further making the case for continued financing.”
She also said that pooled funds are designed to support country-led programs and expertise, aligning financing with national plans rather than creating parallel ones. This approach, she added, embeds progress within national health systems, making improvements in maternal and newborn care sustainable over the long term.
“Ultimately, collaborative funds can catalyse and accelerate progress. But reductions in maternal mortality also depend on domestic financing, political will, and integration into national health strategies. That is how we ensure progress is not just achieved, but sustained,” said Dr Al Mazrouei.
NEST360 transforms newborn care in Africa
Globally, significant progress has been made over the past two decades. Between 2000 and 2023, maternal deaths fell by 40%, stillbirths declined by 30%, neonatal mortality dropped by more than 44%, and under-five mortality fell by over 50%, according to data from the United Nations Inter‑agency Group for Child Mortality Estimation. Despite this progress, sub-Saharan Africa continues to bear the heaviest burden. The region accounts for 46% of global newborn deaths and 47% of stillbirths.
Dr Natasha Rhoda, the Technical Advisory Team Senior Neonatology Advisor for NEST360, said that while more women in sub-Saharan Africa are now giving birth in health facilities, major gaps in the quality of newborn care continue to drive high neonatal mortality rates.
The Newborn Essential Solutions and Technologies Alliance (NEST360) is a global alliance of 23 organisations from Africa, the U.K., and the U.S., working to end preventable infant deaths in African hospitals. Their goal is to strengthen sustainable, high-quality care systems that prevent newborn deaths. NEST360 collaborates with governments, educational institutions, professional societies, and national non-governmental organisations to build sustainable health systems that support lifesaving care to vulnerable newborns in hospitals across Africa. NEST360 has already contributed to measurable progress in countries including Kenya, Malawi, Nigeria, Tanzania, and Ethiopia.
“In regions of sub-Saharan Africa, over 70% of births now occur in health facilities and hospitals. However, Africa’s neonatal mortality rate remains the highest worldwide at about 27 deaths per 1,000 live births,” Dr Rhoda said. “To reduce newborn deaths, hospitals must address existing gaps in access to and quality newborn care. Closing these gaps requires the right infrastructure, the right devices, people with the right skills, and accurate data to support evidence-based improvement strategies, each essential to transforming hospital care and saving lives.”
She said that NEST360 works with governments, educational institutions and national organisations to implement a comprehensive package of care that addresses each essential aspect of high-quality, transformative newborn care. Their approach improves the sustainability and accessibility of high-quality newborn care.
“Working together, we can accelerate progress toward country-specific newborn health targets to help achieve SDG 3.2 and end preventable newborn deaths in Ethiopia, Kenya, Malawi, Nigeria, and Tanzania,” she said.
NEST360’s systems-based approach transforms care for vulnerable babies by building on three pillars. The pillars – technology, education and data – to strengthen hospital systems and improve care for vulnerable newborns. NEST360 catalyses investments from governments and partners at all levels to develop sustainable, locally led systems that improve newborn care in hospitals across Africa. These strategies shift the paradigm for newborn mortality and save lives.
Dr Rhoda said ensuring that innovative technologies reach hospitals and are used effectively requires a systems-based approach.
“To ensure that innovative technologies for small and sick newborns are successfully scaled and integrated into hospital-based care, NEST360 employs a comprehensive strategy that ensures long-term health system readiness,” said Dr Rhoda. “The strategy starts by defining the ‘right equipment’.”
She said NEST360 and UNICEF have partnered to co-define cost and performance target product profiles for newborn equipment used in low-resource settings. These products span six categories identified as pathways to improved care for the most vulnerable babies (Hydration, Nutrition and Drug Delivery, Jaundice Management, Point-of-Care Diagnostics, Infection Prevention and Control, Respiratory Support, and Thermal Management).
She said NEST360 evaluated more than 300 technologies and qualified 41 technologies across 14 newborn product categories for use in hospitals.
“To sustain this product market, NEST360 founded Hatch Technologies, a nonprofit distributor that connects global suppliers with local African distributors, offering warranty services and spare parts that are often unavailable in these regions,” she said.
She added that the model also includes intensive technical mentoring for clinicians and biomedical engineers (BMEs) to support the safe use and maintenance of the equipment. Hatch Technologies currently operates in 11 African countries – Ethiopia, Kenya, Lesotho, Malawi, Nigeria, Rwanda, Tanzania, Uganda, Zambia, Zimbabwe – feedback on technology performance, which they use to improve products.
Measuring success
Dr Rhoda said tracking progress in newborn care depends on strong data systems that allow hospitals to monitor key interventions and outcomes. “We monitor four key indicators, breathing support for preterm babies using CPAP, Kangaroo Mother Care, phototherapy use, and hypothermia prevention, alongside inpatient newborn mortality rates,” she said.
She said that the program maintains a comprehensive, individual, patient-level dataset which includes more than 700,000 newborn admissions to date, with data integrated into government systems. She said early results from hospitals implementing the programme show measurable improvements.
“Data from the first 65 hospitals implementing with NEST360, with phased start dates from 2019 to 2021, show significant mortality changes associated with increased coverage and improved quality of care through hospital-specific coverage targets for priority high-impact interventions, particularly CPAP and Kangaroo Mother Care,” she said.
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She said that NEST360 uses a data dashboard called ‘NEST-IT‘, an online dashboard that supports performance monitoring and quality measurement to inform quality planning and improvement. It is accessible to NEST360 facilities, Ministries of Health (MOH), Funders, and internal team members. The dashboard helps healthcare workers and policymakers make evidence-based decisions, from improving clinical practices to allocating resources such as expanding neonatal wards or strengthening power supply systems in hospitals.
“Ultimately, true sustainability is achieved by integrating NEST360 strategies into national policies, supply chains, and financing mechanisms, ensuring that quality newborn care is protected by government accountability systems long after the initial funding cycle ends,” said Dr Rhoda. “This systemic change is rooted in locally driven data for action, moving beyond top-level government reporting to empower hospital-level clinicians and administrators to identify and address quality-of-care barriers in real time.”
“Historically, newborns have been the forgotten demographic in health planning.”
Dr Rhoda said one of the most significant policy shifts needed to improve newborn survival is for governments to create dedicated investment plans for newborn care.
“Historically, newborns have been the forgotten demographic in health planning, often folded into broader maternal or child health budgets where their specific needs for specialised equipment and clinical expertise are overlooked,” she said. “We see the most transformative shifts to help governments meet the 2030 Sustainable Development Goal (SDG) targets are for countries to develop a Newborn Care Investment Case to support sustainable financing for newborn care that includes human resources.”
She said such an approach safeguards newborn care within national health budgets and should be additionally paired with appointing a dedicated Ministry of Health (MOH) custodian to oversee these funds.
For example, Kenya, one of NEST360’s partner countries, officially launched its Kenya Newborn Investment Case (2025-2030) on November 14, 2025. Under this roadmap, high-quality small and sick newborn care (SSNC) is projected to save up to 47,000 lives by 2030, resulting in a potential return on investment of $8-$13 per dollar invested. The main cost drivers are human resources (particularly skilled nurses) and infrastructure. In other NEST360 countries, such as Tanzania, similar investment cases have been developed or are being developed to support broader resource mobilisation to achieve SDG 3.2 objectives.
“When governments commit to data-driven decision-making and reliable financing, they can build a sustainable strategy to save newborn lives,” said Dr Rhoda.
It’s time for action
Many African countries are way off track to hit the global maternal deaths goals. With just four years until the 2030 Sustainable Development Goals deadline, the challenges are huge, especially as funding for global health shifts and tightens. According to current projections, neonatal mortality in the region will remain twice as high as the 2030 SDG target of 12 deaths per 1,000 live births.
In the absence of urgent investments in maternal, newborn, and child health, health experts warn that the global community will fail to meet the UN Sustainable Development Goals by 2030 in terms of dramatically reducing maternal mortality.
Kang’ethe said the message this International Women’s Day must be both urgent and hopeful. This year’s themes, “Give To Gain” and “Rights. Justice. Action. For ALL Women and Girls,” place maternal and newborn health at the centre of global attention. The message is clear.
“We must invest in quality maternal and newborn care, including enhancing the skills and numbers of the health workforce,” she said. “We must ensure facilities are equipped with essential supplies, equipment and proven innovations to address maternal and newborn mortality”.
She added that financing must match the ambition of ending preventable deaths.
“Governments, donors, philanthropies, and the private sector all play a role in closing funding gaps and sustaining long-term progress,” she said. “If we treat maternal health as a shared responsibility and a development priority, then ending preventable maternal and newborn deaths is not an aspiration. It is an achievable goal.”
Mothers should not be dying from causes we know how to prevent.
Dr Al Mazrouei said the key message the world must hear this International Women’s Day is that maternal deaths on this scale should no longer be happening.
“The message is simple: the solutions exist to end preventable maternal deaths. With sustained investment and collective action, we can transform maternal and newborn care and ensure every mother has the opportunity to watch her child grow,” said Dr Al Mazrouei.
